012The Informant History in the Cognitive Assessment of Older Adults in General Practice

Abstract

Background: Despite its crucial role in the assessment of patients presenting with a memory problem or concern over cognition [1, 2], the utility, availability and conduct of an informant (or collateral) history in general practice has never been formally assessed. Methods: A survey distributed to three separate and nationally representative cohorts of general practitioners (GPs)/GP trainees, followed by a reminder one month later. Results: Ninety-five (14%; 52.2% male) responded. Nearly all (87%; 83/95) indicate that it is most often a family member whom brings possible cognitive impairment to the attention of the GP. The vast majority obtain an informant history in >90% (72.6%; 69/95) or in 75-90% (20%; 19/95) and rate it very useful in their clinical assessment of cognition. The majority report the informant history as readily available and rarely refused, with the general practice environment well-suited to obtaining informant histories. A small minority use the GPCOG informant section to guide the history (3.2%; 3/95). Nearly all (92.6%; 88/95) report having received no training in obtaining informant histories with most (79%; 75/95) welcoming of further training in this area. Conclusions: Despite recognition of the utility and importance of a suitable informant history in the assessment of those with a memory problem, the vast majority of GPs report having never received training in obtaining a suitable informant history and do not use structured tools to guide their interview. Further emphasis on the informant history as a distinct clinical entity on medical curricula, as well as increasing emphasis on the ready availability of structured informant tools, is warranted.