General practitioners' judgment of their elderly patients' cognitive status

J Gen Intern Med. 2009 Dec;24(12):1314-7. doi: 10.1007/s11606-009-1118-2. Epub 2009 Oct 21.


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.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Attitude of Health Personnel
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / psychology
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Judgment*
  • Male
  • Middle Aged
  • Physician-Patient Relations*
  • Physicians, Family / standards*