The journal of nutrition, health & aging

, Volume 14, Issue 8, pp 697–702 | Cite as

Do general practitioners recognize mild cognitive impairment in their patients?

  • Hanna Kaduszkiewicz
  • T. Zimmermann
  • H. van Den Bussche
  • C. Bachmann
  • B. Wiese
  • H. Bickel
  • E. Mösch
  • H. -P. Romberg
  • F. Jessen
  • G. Cvetanovska-Pllashniku
  • W. Maier
  • S. G. Riedel-Heller
  • M. Luppa
  • H. Sandholzer
  • S. Weyerer
  • M. Mayer
  • A. Hofmann
  • A. Fuchs
  • H.-H. Abholz
  • M. Pentzek
JNHA: Clinical Trials and Aging

Abstract

Objectives

The need for recognition of mild cognitive impairment (MCI) in primary care is increasingly discussed because MCI is a risk factor for dementia. General Practitioners (GPs) could play an important role in the detection of MCI since they have regular and long-term contact with the majority of the elderly population. Thus the objective of this study is to find out how well GPs recognize persons with MCI in their practice population.

Design

Cross-sectional study.

Setting

Primary care chart registry sample.

Participants

3,242 non-demented GP patients aged 75–89 years.

Measurements

GPs assessed the cognitive status of their patients on the Global Deterioration Scale (GDS). Thereafter, trained interviewers collected psychometric data by interviewing the patients at home. The interview data constitute the basis for the definition of MCI cases (gold standard).

Results

The sensitivity of GPs to detect MCI was very low (11–12%) whereas their specificity amounts to 93–94%. Patients with MCI with a middle or high level of education more often got a false negative assignment than patients with a low educational level. The risk of a false positive assignment rose with the patients’ degree of comorbidity. GPs were better at detecting MCI when memory or two and more MCIdomains were impaired.

Conclusion

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.

Key words

Mild cognitive impairment recognition primary care early detection dementia 

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Copyright information

© Serdi and Springer Verlag France 2010

Authors and Affiliations

  • Hanna Kaduszkiewicz
    • 1
    • 12
  • T. Zimmermann
    • 1
  • H. van Den Bussche
    • 1
  • C. Bachmann
    • 1
  • B. Wiese
    • 3
  • H. Bickel
    • 2
  • E. Mösch
    • 2
  • H. -P. Romberg
    • 4
  • F. Jessen
    • 5
  • G. Cvetanovska-Pllashniku
    • 5
  • W. Maier
    • 5
  • S. G. Riedel-Heller
    • 6
  • M. Luppa
    • 6
  • H. Sandholzer
    • 7
  • S. Weyerer
    • 8
  • M. Mayer
    • 9
  • A. Hofmann
    • 10
  • A. Fuchs
    • 11
  • H.-H. Abholz
    • 11
  • M. Pentzek
    • 11
  1. 1.Department of Primary Medical Care, Center for Psychosocial MedicineUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Clinic and Polyclinic for Psychiatry and PsychotherapyMunich Technical UniversityMunichGermany
  3. 3.Center of Biometrics and Medical InformaticsHanover Medical SchoolHanoverGermany
  4. 4.BonnGermany
  5. 5.Department of Psychiatry and PsychotherapyUniversity of BonnBonnGermany
  6. 6.Department of PsychiatryUniversity of LeipzigLeipzigGermany
  7. 7.Independent Department of General Medicine PracticeUniversity of LeipzigLeipzigGermany
  8. 8.Central Institute of Mental HealthMannheimGermany
  9. 9.MannheimGermany
  10. 10.MunichGermany
  11. 11.Department of General PracticeUniversity Medical Center DüsseldorfDüsseldorfGermany
  12. 12.Department of Primary Medical Care, Center for Psychosocial MedicineUniversity Medical Center Hamburg-EppendorfHamburgGermany

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