Abstract
BackgroundSubjective memory complaints (SMC) are common among elderly patients and little is know about the association between SMC and health care utilisation. Thus, the aim of this study was to investigate health care utilisation during a three-year follow-up among elderly patients consulting their general practitioner and reporting subjective memory complaints (SMC).MethodsThis study was conducted as a prospective cohort survey in general practice with three-year follow-up. Selected health care utilisation or costs relative to SMC adjusted for potential confounders were analyzed in a two-part model where the incidence of use of a selected health care service were analyzed separately from the quantity of use for those that use the service. The former analyzed in a Poisson regression approach, the latter in a generalized linear regression model.ResultsA total 758 non-nursing home residents aged 65 years and older consulted their GP in October and November 2002 and participated in the present study. The adjusted probability of nursing home placement was significantly increased in subjects with SMC relative to subjects without SMC (RR = 2.3). More generally, SMC was associated with an increase in the cost of selected health care utilisation of 60% over three years (p = 0.003).ConclusionThe data of this study indicated that in an elderly primary care population the presence of SMC increased the cost of health care utilisation by 60% over three years. Thus, inquiry into SMC may contribute to a risk profile assessment of elderly patients and may identify patients with an increased use of health care services.
Highlights
Subjective memory complaints (SMC) are common among elderly patients and little is know about the association between subjective memory complaints (SMC) and health care utilisation
A Danish study indicated that these patients rarely share their perception of SMC with their General Practitioner (GP) spontaneously [6], even though SMC may identify frail patients and inquiry into SMC may be implemented in a busy GP routine consultation
The final cohort consisted of 775 non-nursing home residents of which 758 filled out the SMC item
Summary
Subjective memory complaints (SMC) are common among elderly patients and little is know about the association between SMC and health care utilisation. The aim of this study was to investigate health care utilisation during a three-year follow-up among elderly patients consulting their general practitioner and reporting subjective memory complaints (SMC). In studies of older patients, the reported prevalence of subjective memory complaints (SMC) shows a huge variation with figures ranging from 10-56% [1,2]. Association has been found between memory complaints and cognitive impairment on testing, even after adjustment for depressive symptoms [7,8]. Longitudinal studies assessing the value of SMC in predicting dementia or cognitive decline have shown varying results [9,10,11,12,13,14,15,16]. The nature of SMC is complex [17]
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