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General Practitioners’ Judgment of their Elderly Patients’ Cognitive Status

Authors
  • Pentzek, Michael1
  • Fuchs, Angela1
  • Wiese, Birgitt2
  • Cvetanovska-Pllashniku, Gabriela3
  • Haller, Franziska3
  • Maier, Wolfgang3
  • Riedel-Heller, Steffi G.4
  • Angermeyer, Matthias C.5
  • Bickel, Horst6
  • Mösch, Edelgard6
  • Weyerer, Siegfried7
  • Werle, Jochen7
  • van den Bussche, Hendrik8
  • Eisele, Marion8
  • Kaduszkiewicz, Hanna8
  • 1 University Medical Center Düsseldorf, Department of General Practice, Moorenstraße 5, Düsseldorf, 40225, Germany , Düsseldorf (Germany)
  • 2 Hannover Medical School, Center of Biometrics and Medical Informatics, Hannover, 30625, Germany , Hannover (Germany)
  • 3 University of Bonn, Department of Psychiatry, Bonn, 53105, Germany , Bonn (Germany)
  • 4 University of Leipzig, Public Health Research Unit, Department of Psychiatry, Leipzig, 04317, Germany , Leipzig (Germany)
  • 5 Center for Public Mental Health, Gösing am Wagram, 3482, Austria , Gösing am Wagram (Austria)
  • 6 Munich Technical University, Clinic and Polyclinic for Psychiatry and Psychotherapy, Munich, 81675, Germany , Munich (Germany)
  • 7 Central Institute of Mental Health, Mannheim, 68159, Germany , Mannheim (Germany)
  • 8 University Medical Center Hamburg-Eppendorf, Department for Primary Medical Care, Center of Psychosocial Medicine, Martinistraße 52, Hamburg, 20246, Germany , Hamburg (Germany)
Type
Published Article
Journal
Journal of General Internal Medicine
Publisher
Springer-Verlag
Publication Date
Oct 21, 2009
Volume
24
Issue
12
Identifiers
DOI: 10.1007/s11606-009-1118-2
Source
Springer Nature
Keywords
License
Yellow

Abstract

BackgroundGeneral practitioners (GP) play an important role in detecting cognitive impairment among their patients.ObjectivesTo explore factors associated with GPs’ judgment of their elderly patients’ cognitive status.DesignCross-sectional data from an observational cohort study (AgeCoDe study); General practice surgeries in six German metropolitan study centers; home visits by interviewers.Participants138 GPs, 3,181 patients (80.13 ± 3.61 years, 65.23% female).MeasurementsGeneral practitioner questionnaire for each patient: familiarity with the patient, patient morbidity, judgment of cognitive status. Home visits by trained interviewers: sociodemographic and clinical data, psychometric test performance. Multivariate regression analysis was used to identify independent associations with the GPs’ judgment of “cognitively impaired” vs. “cognitively unimpaired.”ResultsLess familiar patients (adjusted odds ratio [aOR] 2.42, 95% CI 1.35–4.32, for poor vs. very high familiarity), less mobile patients (aOR 1.29, 95% CI 1.13–1.46), patients with impaired hearing (aOR 5.46, 95% CI 2.35–12.67 for serious vs. no problems), and patients with greater comorbidity (aOR 1.15, 95% CI 1.08–1.22) were more likely to be rated as “cognitively impaired” by their GPs.ConclusionsThe associations between GPs’ assessments of cognitive impairment and their familiarity with their patients and patients’ mobility, hearing, and morbidity provide important insights into how GPs make their judgments.

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