{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:21:00Z","timestamp":1791271260553,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2004,9,23]],"date-time":"2004-09-23T00:00:00Z","timestamp":1095897600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2004,10]]},"abstract":"<jats:p>\n                    <jats:bold>Objectives:<\/jats:bold>\n                    To identify characteristics of older primary care patients who were cognitively impaired and who underwent mental status testing by their physicians.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design:<\/jats:bold>\n                    Cross\u2010sectional and retrospective analysis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Setting:<\/jats:bold>\n                    Seven small\u2010town primary care practices.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Participants:<\/jats:bold>\n                    A total of 1,107 patients with a mean\u00b1standard deviation age of 76.3\u00b16.6, screened using the Mini\u2010Mental State Examination (MMSE); medical records reviewed.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Measurements:<\/jats:bold>\n                    Demographics, MMSE, medical record information. Odds ratios (OR) with 95% confidence intervals (CI), adjusted for age, sex, and education.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Thirty\u2010one 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\u20132.8), basic activity of daily living (ADL) impairment in 7.9% (OR=2.4, 95% CI=1.3\u20134.4), 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\u20136.8), and prescription of cholinesterase inhibitors in 7.6% (OR=4.4, 95% CI=1.9\u201310.2). 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\u20135.6) or impaired IADLs (OR=2.7, 95% CI=1.4\u20135.2), diagnosed dementia (OR=4.9, 95% CI=2.8\u20138.6), referred to specialists (OR=6.3, 95% CI=2.5\u201316.2) or social services (OR=3.6, 95% CI=1.8\u20137.3), or prescribed cholinesterase inhibitors (OR=8.5, 95% CI=4.2\u201317.5).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    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.\n                  <\/jats:p>","DOI":"10.1111\/j.1532-5415.2004.52459.x","type":"journal-article","created":{"date-parts":[[2004,9,23]],"date-time":"2004-09-23T05:21:19Z","timestamp":1095916879000},"page":"1668-1675","source":"Crossref","is-referenced-by-count":94,"title":["Detection and Management of Cognitive Impairment in Primary Care: The Steel Valley Seniors Survey"],"prefix":"10.1111","volume":"52","author":[{"given":"Mary","family":"Ganguli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Rodriguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit","family":"Mulsant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Richards","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Pandav","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joni Vander","family":"Bilt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroko H.","family":"Dodge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary P.","family":"Stoehr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Saxton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard K.","family":"Morycz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert T.","family":"Rubin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry","family":"Farkas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven T.","family":"DeKosky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,9,23]]},"reference":[{"key":"e_1_2_6_2_2","first-page":"425","article-title":"Screening for cognitive impairment in the elderly","volume":"144","author":"Canadian Task Force on the Periodic Health Examination.","year":"1991","journal-title":"Can Med Assoc J"},{"key":"e_1_2_6_3_2","volume-title":"Canadian Task Force on the Periodic Health Examination. 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