Factors Associated With Primary Care Physicians' Recognition of Cognitive Impairment in Their Older Patients.

Factors Associated With Primary Care Physicians' Recognition of Cognitive Impairment in Their Older Patients. Alzheimer Dis Assoc Disord. 2014 Mar 13; Authors: Tierney MC, Naglie G, Upshur R, Jaakkimainen L, Moineddin R, Charles J, Ganguli M Abstract Although there are accurate screens for cognitive impairment, there is as yet no evidence that screening improves outcomes including primary care physicians' (PCP) medical decision making. PCPs' recognition of cognitive impairment being suboptimal, we investigated factors associated with improved recognition. Eligible patients were aged 65 years and above, without documented dementia or previous work-up for dementia, seen consecutively over 2 months by one of 13 PCPs. PCPs indicated whether they, the patient, or the family had concerns about each patient's cognition. We enrolled 130 patients with any cognitive concerns and a matched sample of 133 without cognitive concerns, and administered standardized neuropsychological tests. PCP's judgments of cognitive concern showed 61% sensitivity and 86% specificity against the neuropsychological standard. When combined with a Mini-Mental State Examination score ≤26, PCP recognition improved in sensitivity (82%) with some loss in specificity (74%). True positives increased when PCPs' practices included more cognitively impaired patients and when patients reported poor memory. False positives increased when patients had diabetes, reported poor memory, or ...
Source: Alzheimer Disease and Associated Disorders - Category: Psychiatry Tags: Alzheimer Dis Assoc Disord Source Type: research