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Subjective memory impairment in general practice

Short overview and design of a mixed methods study
Beiträge zum Themenschwerpunkt

Abstract

Background

Public awareness for dementia is rising and patients with concerns about forgetfulness are not uncommon in general practice. For the general practitioner (GP) subjectively perceived memory impairment (SMI) also offers a chance to broach the issue of cognitive function with the patient. This may support GPs’ patient-centered care in terms of a broader frailty concept.

Objective

What is SMI (definition, operationalization, prevalence and burden)? Which conceptions and approaches do GPs have regarding SMI?

Methods

Narrative overview of recent SMI criteria and results, selective utilization of results from a systematic literature search on GP dementia care, non-systematic search regarding SMI in general practice, deduction of a study design from the overview and development according to international standards.

Results

Studies revealed that approximately 60% of GP patients aged >74 reported a declining memory, every sixth person had concerns about this aspect and only relatively few seek medical advice. Concerns about SMI are considered a risk factor for future dementia. Specific general practice conceptions about SMI could not be identified in the literature. Using guidelines for mixed methods research, the design of an exploratory sequential mixed methods study is presented, which should reveal different attitudes of GPs towards SMI.

Conclusion

Subjective memory impairment (SMI) is a common feature and troubles a considerable proportion of patients. Neuropsychiatric research is progressing, but for the transfer of the SMI concept into routine practice, involvement of GP research is necessary. A new study aims to make a contribution to this.

Keywords

Dementia Cognition Health services research Attitudes of health personnel Physician-patient relations 

Subjektive Gedächtnisbeeinträchtigungen in der Hausarztpraxis

Kurzer Überblick und Design einer Mixed-methods-Studie

Zusammenfassung

Hintergrund

Die öffentliche Aufmerksamkeit für Demenz wächst; in der Hausarztpraxis kann sich dies in Sorgen der PatientenInnen um das eigene Gedächtnis äußern. Für den Hausarzt/die Hausärztin bieten solche patientenseitig wahrgenommenen Gedächtnisprobleme („subjective memory impairment“, SMI) u. a. die Möglichkeit, ein Gespräch über das Gedächtnis zu führen. Dies kann die hausärztliche Versorgung im Sinne eines erweiterten Frailty-Konzepts unterstützen.

Fragestellung

Was ist SMI (Definition, Operationalisierung, Prävalenz, Bedeutung)? Welche Konzepte von SMI und Umgangsstrategien mit SMI haben Hausärzte/-ärztinnen?

Methoden

Narrative Übersicht aktueller SMI-Kriterien und -Daten; selektive Nutzung der Ergebnisse einer systematischen Literaturrecherche zur hausärztlichen Demenzversorgung; nicht-systematische Recherche zu SMI in der Hausarztpraxis; Ableitung eines Studiendesigns aus der Literaturübersicht und Entwicklung anhand internationaler Standards.

Ergebnisse

Laut Studienlage geben ca. 60 % der HausarztpatientInnen im Alter >74 ein nachlassendes Gedächtnis an. Sorgen darüber macht sich jeder Sechste; weitaus weniger suchen aktiv ärztlichen Rat. Sorgen um SMI gelten als Risikofaktor für eine spätere Demenz. Spezifisch hausärztliche SMI-Konzepte konnten in der Literatur nicht gefunden werden. Anhand von Standards für Forschung mit kombinierter qualitativer und quantitativer Methodik wird das Design einer exploratorischen sequenziellen „Mixed-methods“-Studie dargestellt, die über die verschiedenen Einstellungen zu SMI unter Hausärzten/-ärztinnen Aufschluss geben soll.

Diskussion

„Subjective memory impairment“ ist häufig und beunruhigt einen deutlichen Teil der PatientenInnen. Die neuropsychiatrische Forschung zu SMI geht voran. Für die Umsetzung des Konzepts in die Praxis ist jedoch die Beteiligung allgemeinmedizinischer Forschung unabdingbar. Eine neue Studie soll dazu beitragen.

Schlüsselwörter

Demenz Kognition Allgemeinmedizin Einstellungen Arzt-Patient-Beziehung 

Notes

Funding

The SMI-GP study is funded by the Research Committee of the Medical Faculty, Heinrich-Heine University Düsseldorf (grant no. 43/2015).

Compliance with ethical guidelines

Conflict of interest

M. Pentzek, V. Leve and V. Leucht declare that they have no competing interests.

This article does not contain any studies with patients or animals performed by any of the authors. The presented study design was approved by the Ethics Commission of the Medical Faculty, Heinrich-Heine University Düsseldorf (study no. 4848).

The supplement containing this article is not sponsored by industry.

Supplementary material

391_2017_1207_MOESM1_ESM.docx (14 kb)
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Copyright information

© Springer Medizin Verlag GmbH 2017

Authors and Affiliations

  1. 1.Institute of General Practice (ifam) / Centre for Health and Society (chs)Medical Faculty, Heinrich-Heine University DüsseldorfDüsseldorfGermany

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