Physician recognition of cognitive impairment: evaluating the need for improvement.

摘要: Objectives: To assess physician recognition of dementia and cognitive impairment, compare with documentation, identify patient factors associated recognition. Design: Survey physicians review medical records. Setting: Health maintenance organization in southern California. Participants: Seven hundred twenty-nine who provided care for women participating a cohort study memory (Women's Memory Study). Measurements: Percentage patients or impairment (using the Telephone Interview Cognitive Status supplemented by Dementia Questionnaire) recognized physicians. Relationship between characteristics demographics, practice characteristics, training, knowledge, attitudes about dementia. Results: Physicians (n=365) correctly identified 81% 44% without definite dementia. Medical records documented 83% 26% In multivariable model, geriatric credentials (defined as fellowship experience and/or certificate added qualifications) more often than did those (risk ratio (RR)=1.56, 95% confidence interval (CI)=1.04–1.66). were likely to recognize history depression treatment (RR=1.3, CI=1.03–1.45) stroke (RR=1.37, CI=1.04–1.45) less (RR=0.46, CI=0.23–0.72) prior hospitalization myocardial infarction (RR=0.37, CI=0.09–0.88) cancer (RR=0.49, CI=0.18–0.90). Conclusion: record documentation reflects dementia, yet are aware of, but have not documented, many milder impairment. unaware 40% their cognitively impaired patients. Additional geriatrics training may promote recognition, systems solutions needed improve critical provision emerging therapies early