TY - JOUR
T1 - Discrepancies in information provided to primary care physicians by patients with and without dementia
T2 - The Steel Valley Seniors Survey
AU - Ganguli, Mary
AU - Du, Yangchun
AU - Rodriguez, Eric G.
AU - Mulsant, Benoit H.
AU - McMichael, Kathryn A.
AU - Bilt, Joni Vander
AU - Stoehr, Gary P.
AU - Dodge, Hiroko H.
N1 - Funding Information:
Supported in part by grants # R01 AG16705, K24 AG033035, and K01 AG023014 from the National Institute on Aging, NIH, U.S. Department of Health and Human Services .
PY - 2006/5
Y1 - 2006/5
N2 - Objective: The objective of this study was to examine associations between discrepancies in health information provided to primary care providers and severity of impairment in older patients with and without dementia. Methods: This study included brief assessment and medical record review of 1,107 patients with a mean (standard deviation) age of 76.3 (6.6) years (range: 65-100 years) in seven small-town primary care practices. In 358 patients, detailed in-home assessment included demographics; dementia by Clinical Dementia Rating (CDR) scale; and frequencies of memory complaints, falls, and inadvertent medication nonadherence determined from medical records and standardized in-home research assessments. Main outcome variables were trends in discrepancies between chart reviews and research assessments. Main explanatory variable was CDR box total scores. Results: Proportions of patients reporting memory complaints and falls, and evidence of inadvertent nonadherence, in the charts and by research assessment increased with CDR. Discrepancies between medical record and research assessment, were also associated with CDR, showing linear trends for memory complaints and inadvertent nonadherence and a quadratic trend for falls. Conclusion: Memory complaints, falls, and inadvertent medication nonadherence increase with dementia severity. The levels of discrepancy between information patients provided to their physicians and information they provided in response to detailed, standardized assessments, also varied with dementia severity. Physicians should be alert to the possibility of receiving unreliable health information from even mildly demented patients, whether or not dementia has been detected.
AB - Objective: The objective of this study was to examine associations between discrepancies in health information provided to primary care providers and severity of impairment in older patients with and without dementia. Methods: This study included brief assessment and medical record review of 1,107 patients with a mean (standard deviation) age of 76.3 (6.6) years (range: 65-100 years) in seven small-town primary care practices. In 358 patients, detailed in-home assessment included demographics; dementia by Clinical Dementia Rating (CDR) scale; and frequencies of memory complaints, falls, and inadvertent medication nonadherence determined from medical records and standardized in-home research assessments. Main outcome variables were trends in discrepancies between chart reviews and research assessments. Main explanatory variable was CDR box total scores. Results: Proportions of patients reporting memory complaints and falls, and evidence of inadvertent nonadherence, in the charts and by research assessment increased with CDR. Discrepancies between medical record and research assessment, were also associated with CDR, showing linear trends for memory complaints and inadvertent nonadherence and a quadratic trend for falls. Conclusion: Memory complaints, falls, and inadvertent medication nonadherence increase with dementia severity. The levels of discrepancy between information patients provided to their physicians and information they provided in response to detailed, standardized assessments, also varied with dementia severity. Physicians should be alert to the possibility of receiving unreliable health information from even mildly demented patients, whether or not dementia has been detected.
KW - Cognition
KW - Falls
KW - Medication adherence
KW - Memory
KW - Under-reporting
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U2 - 10.1097/01.JGP.0000199340.17808.77
DO - 10.1097/01.JGP.0000199340.17808.77
M3 - Article
C2 - 16670249
AN - SCOPUS:33646445594
SN - 1064-7481
VL - 14
SP - 446
EP - 455
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
IS - 5
ER -