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Comparative Study
. 2009 Dec;24(12):1314-7.
doi: 10.1007/s11606-009-1118-2. Epub 2009 Oct 21.

General practitioners' judgment of their elderly patients' cognitive status

Michael Pentzek  1 , Angela Fuchs, Birgitt Wiese, Gabriela Cvetanovska-Pllashniku, Franziska Haller, Wolfgang Maier, Steffi G Riedel-Heller, Matthias C Angermeyer, Horst Bickel, Edelgard Mösch, Siegfried Weyerer, Jochen Werle, Hendrik van den Bussche, Marion Eisele, Hanna Kaduszkiewicz; AgeCoDe study group
Collaborators, Affiliations
Comparative Study

General practitioners' judgment of their elderly patients' cognitive status

Michael Pentzek et al. J Gen Intern Med. 2009 Dec.

Abstract

Background: General practitioners (GP) play an important role in detecting cognitive impairment among their patients.

Objectives: To explore factors associated with GPs' judgment of their elderly patients' cognitive status.

Design: Cross-sectional data from an observational cohort study (AgeCoDe study); General practice surgeries in six German metropolitan study centers; home visits by interviewers.

Participants: 138 GPs, 3,181 patients (80.13 +/- 3.61 years, 65.23% female).

Measurements: General 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."

Results: Less 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.

Conclusions: The 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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