The impact of dementia on the use of general practitioners among the elderly in Norway

Scand J Prim Health Care. 2015;33(3):199-205. doi: 10.3109/02813432.2015.1067516. Epub 2015 Aug 20.

Abstract

Objective: To assess the use of general practitioners (GPs), in elderly home-dwelling persons in Norway and explore the impact of cognitive decline, age, and living situation.

Design: Prospective longitudinal study.

Setting: Data were collected from municipalities in four counties in Norway in the period from January 2009 to August 2012.

Subjects: Home-dwelling persons 70 years of age or older, receiving in-home care.

Main outcome measures: Use of GPs over a period of 18 months related to cognitive state, functional status, neuropsychiatric symptoms, and demographics.

Results: A total of 599 persons were included. The mean annual number of consultations per participant was 5.6 (SD = 5.4). People with moderate to severe dementia had fewer consultations per year compared with those with mild or no dementia (3.7 versus 5.8 per year, p = 0.004). In the multivariate model higher age predicted fewer consultations while affective neuropsychiatric symptoms were associated with an increase in frequency of consultations. The most frequent reason to consult a GP was cardiovascular diseases (36.8% of all consultations), followed by musculoskeletal complaints (12.1%) and psychiatric diagnoses (8.7%).

Conclusion: Our study shows that the home-dwelling elderly with moderate to severe dementia in Norway consult their GP less often than persons with mild or no dementia. This could indicate a need for better interaction between the municipal care and social services and the general practitioners.

Keywords: Dementia; Norway; emergency service; general practice; general practitioner; municipal care.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Dementia* / therapy
  • Female
  • General Practice*
  • General Practitioners
  • Health Services Needs and Demand
  • Health Services for the Aged / statistics & numerical data*
  • Home Care Services
  • Humans
  • Longitudinal Studies
  • Male
  • Motivation
  • Norway
  • Patient Acceptance of Health Care*
  • Practice Patterns, Physicians'
  • Prospective Studies
  • Referral and Consultation