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首页> 外文期刊>International psychogeriatrics >Predictors of agreement between general practitioner detection of dementia and the revised Cambridge Cognitive Assessment (CAMCOG-R)
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Predictors of agreement between general practitioner detection of dementia and the revised Cambridge Cognitive Assessment (CAMCOG-R)

机译：全科医生痴呆症检测与修订的剑桥认知评估（CAMCOG-R）之间的一致性预测指标

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Background: Dementia is a complex and variable condition which makes recognition of it particularly difficult in a low prevalence primary care setting. This study examined the factors associated with agreement between an objective measure of cognitive function (the revised Cambridge Cognitive Assessment, CAMCOG-R) and general practitioner (GP) clinical judgment of dementia. Methods: This was a cross-sectional study involving 165 GPs and 2,024 community-dwelling patients aged 75 years or older. GPs provided their clinical judgment in relation to each of their patient's dementia status. Each patient's cognitive function and depression status was measured by a research nurse using the CAMCOG-R and the 15-item Geriatric Depression Scale (GDS), respectively. Results: GPs correctly identified 44.5% of patients with CAMCOG-R dementia and 90% of patients without CAMCOG-R dementia. In those patients with CAMCOG-R dementia, two patient-dependent factors were most important for predicting agreement between the CAMCOG-R and GP judgment: the CAMCOG-R score (p = 0.006) and patient's mention of subjective memory complaints (SMC) to the GP (p = 0.040). A higher CAMCOG-R (p < 0.001) score, female gender (p = 0.005), and larger practice size (p < 0.001) were positively associated with GP agreement that the patient did not have dementia. Subjective memory complaints (p < 0.001) were more likely to result in a false-positive diagnosis of dementia. Conclusions: Timely recognition of dementia is advocated for optimal dementia management, but early recognition of a possible dementia syndrome needs to be balanced with awareness of the likelihood of false positives in detection. Although GPs correctly agree with dimensions measured by the CAMCOG-R, improvements in sensitivity are required for earlier detection of dementia.
机译：背景：痴呆症是一种复杂多变的疾病，在低患病率的初级保健机构中，对其进行识别尤其困难。这项研究检查了与认知功能的客观测量（修订的剑桥认知评估，CAMCOG-R）和全科医生（GP）痴呆症临床判断之间的一致性相关的因素。方法：这是一项横断面研究，涉及165名全科医生和2,024名年龄在75岁或75岁以上的社区居民患者。全科医生提供有关他们每个患者痴呆状态的临床判断。一位研究护士分别使用CAMCOG-R和15个项目的老年抑郁量表（GDS）对每个患者的认知功能和抑郁状态进行了测量。结果：GP正确地识别出44.5％的CAMCOG-R痴呆患者和90％的无CAMCOG-R痴呆患者。在那些患有CAMCOG-R痴呆的患者中，两个依赖于患者的因素对于预测CAMCOG-R和GP判断之间的一致性最重要：CAMCOG-R评分（p = 0.006）和患者提及主观记忆障碍（SMC） GP（p = 0.040）。较高的CAMCOG-R评分（p <0.001），女性（p = 0.005）和较大的练习量（p <0.001）与患者无痴呆的GP协议呈正相关。主观记忆障碍（p <0.001）更有可能导致痴呆的假阳性诊断。结论：提倡及时识别痴呆症，以实现最佳的痴呆管理，但早期识别可能的痴呆综合症需要与对检测出假阳性的可能性的认识相平衡。尽管GP正确地符合CAMCOG-R测量的尺寸，但仍需要提高灵敏度才能早期发现痴呆症。

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