Published in:
01-12-2009 | Brief Report
General Practitioners’ Judgment of their Elderly Patients’ Cognitive Status
Published in: Journal of General Internal Medicine | Issue 12/2009
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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.