Objectives: To identify characteristics of older primary care patients who were cognitively impaired and who underwent mental status testing by their physicians.
Design: Cross-sectional and retrospective analysis.
Setting: Seven small-town primary care practices.
Participants: A total of 1,107 patients with a mean+/-standard deviation age of 76.3+/-6.6, screened using the Mini-Mental State Examination (MMSE); medical records reviewed.
Measurements: Demographics, MMSE, medical record information. Odds ratios (OR) with 95% confidence intervals (CI), adjusted for age, sex, and education.
Results: Thirty-one percent of the sample had MMSE scores of less than 25. Among these patients, physicians documented memory loss in only 23% which was significantly more often than in the higher scoring group (OR=1.9, 95% CI=1.3-2.8), basic activity of daily living (ADL) impairment in 7.9% (OR=2.4, 95% CI=1.3-4.4), instrumental ADL (IADL) impairment in 6.7% (OR=2.2, 95% CI=1.1=4.2), dementia in 12.2% (OR=3.7, 95% CI=2.0-6.8), and prescription of cholinesterase inhibitors in 7.6% (OR=4.4, 95% CI=1.9-10.2). Physicians recorded mental status testing largely in patients with research MMSE scores of 24 to 28, significantly more often when they also documented memory loss (OR=3.8, 95% CI=2.5-5.6) or impaired IADLs (OR=2.7, 95% CI=1.4-5.2), diagnosed dementia (OR=4.9, 95% CI=2.8-8.6), referred to specialists (OR=6.3, 95% CI=2.5-16.2) or social services (OR=3.6, 95% CI=1.8-7.3), or prescribed cholinesterase inhibitors (OR=8.5, 95% CI=4.2-17.5).
Conclusion: Physicians noted impairment in a minority of impaired patients. They tested mental status in those with documented cognitive and functional difficulties, in very mildly impaired patients, and in those for whom they intervened.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/j.1532-5415.2004.52459.x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Adenoid cystic carcinoma of the breast, from diagnosis to management: a case report.
J Med Case Rep
January 2025
Department of Pathology and Laboratories, University Hospital Fundación Santa Fe de Bogotá, Bogotá, DC, Colombia.
Background: Adenoid cystic carcinoma of the breast is a rare subtype, constituting less than 3.5% of primary breast carcinomas. Despite being categorized as a type of triple-negative breast cancer, it generally has a favorable prognosis.
View Article and Find Full Text PDFIntegration of physical and mental health services for children and young people with eating disorders and functional symptom disorders: discrete choice experiment.
BMC Health Serv Res
January 2025
Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK.
Background: Given the increasing recognition of the value of greater integration of physical and mental health services for children and young people, we aimed to evaluate preferences among parents for the characteristics associated with integrated health service provision for two conditions (eating disorders, functional symptom disorders).
Methods: Two discrete choice experiments (DCEs) were conducted, using electronic surveys. Participants were adult parents of children and young people.
Modulating delirium through stimulation (MoDeSt): study protocol for a randomized, double-blind, sham-controlled trial assessing the effect of postoperative transcranial electrical stimulation on delirium incidence.
Trials
January 2025
Department of Neurology, Universitätsmedizin Greifswald, Fleischmannstraße 6, Greifswald, 17489, Germany.
Background: Postoperative delirium (POD) is the most common neurological adverse event among elderly patients undergoing surgery. POD is associated with an increased risk for postoperative complications, long-term cognitive decline, an increase in morbidity and mortality as well as extended hospital stays. Delirium prevention and treatment options are currently limited.
View Article and Find Full Text PDFProviding an e-cigarette starter kit for smoking cessation and reduction as adjunct to usual care to smokers with a mental health condition: findings from the ESCAPE feasibility study.
BMC Psychiatry
January 2025
Department of Behavioural Science and Health, University College London, London, 1-19 Torrington Place, WC1E 7HB, UK.
Background: Smoking rates in the UK have declined steadily over the past decades, masking considerable inequalities, as little change has been observed among people with a mental health condition. This trial sought to assess the feasibility and acceptability of supplying an electronic cigarette (e-cigarette) starter kit for smoking cessation as an adjunct to usual care for smoking cessation, to smokers with a mental health condition treated in the community, to inform a future effectiveness trial.
Methods: This randomised controlled feasibility trial, conducted March-December 2022, compared the intervention (e-cigarette starter kit with a corresponding information leaflet and demonstration with Very Brief Advice) with a 'usual care' control at 1-month follow-up.
Designing and incorporating integrated oral health care pathways for pediatric and adult patients: touchpoints in a dental setting.
BMC Oral Health
January 2025
National Center for Professional Training, Ministry of Health and Medical Education, Tehran, Iran.
Background: Maintenance of oral health, prevention, and health promotion stand as primary competencies for dental graduates. Consequently, it is necessary to promote such an approach in dental schools, which are traditionally focused on treatment, to improve the attitude and practice of students in the field of prevention, the final result of which is the reduction of oral and dental diseases in patients. The study aimed to design Integrated Oral Health Care Pathways (IOHCPs) for adults and children referred to Tehran University of Medical Sciences (TUMS), School of Dentistry.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!