Do general practitioners recognize mild cognitive impairment in their patients?

Abstract

The results show that GPs recognise MCI in a very limited number of cases when based on clinical impression only. A further development of the MCI concept and its operationalisation is necessary. Emphasis should be placed on validated, reliable and standardised tests for routine use in primary care encompassing other than only cognitive domains and on case finding approaches rather than on screening. Then a better attention and qualification of GPs with regard to the recognition of MCI might be achievable.

A comparative study demonstrated that prevalence figures on multimorbidity require cautious interpretation when drawn from a single database

“…On the other hand, preliminary comparisons of baseline and follow-up data in the MC-Cohort study show that PCPs underreported an average of 0.7 chronic conditions in both interviews, suggesting that the actual prevalence in the MC-Cohort population is even higher. Also, PCPs may overlook complaints not presented by the patient or complaints that the PCPs do not consider to be severe or precise enough, for example, mental health complaints [20] or cognitive impairment [21,22]. As a result, caution is indicated when estimating multimorbidity prevalence as small differences in study design may have great consequences on figures.…”

P3–222: Detection of mild cognitive impairment and early‐stage dementia with an audio‐recorded cognitive scale

“…The selection of a cut-off point of .80 results in a 14.3% false positive rate and a 30% false negative rate. This represents a significant improvement over the literature reporting that more than half of primary care physicians miss a dementia diagnosis (Valcour et al, 2000, Kaduszkiewicz et al, 2010. …”

“…The need to assess cognitive function in the elderly is imperative since primary care physicians often do not detect early AD and MCI, with reports that more than half the cases are unrecognized (Valcour et al, 2000;Kaduszkiewicz et al, 2010). Reliance on a subjective memory complaint for early detection is not advisable because it is a common complaint that is neither sensitive nor specific to objective cognitive deficits (Purser et al, 2006).…”

Use of Addenbrooke’s cognitive examination-revised to evaluate the patients’ state in general medical practice

“…Од-нако в условиях территориальной поликлиники или сома-тического стационара оно далеко не всегда доступно. В результате показатели выявления когнитивных наруше-ний в общемедицинской сети остаются низкими, особен-но когда диагностика основывается только на клиниче-ском впечатлении врача [10,11]. Все это обусловливает необходимость применения в общемедицинской практи-ке простых и надежных психометрических инструментов для ранней диагностики когнитивных расстройств.…”