O'Connor D W, Fertig A, Grande M J, Hyde J B, Perry J R, Roland M O, Silverman J D, Wraight S K
Heatherton Hospital, Victoria, Australia.
Br J Gen Pract. 1993 May;43(370):185-8.
General practitioners are often reluctant to administer brief cognitive tests, and to question the relatives of patients who appear to be demented, for fear of causing distress. Diagnoses of dementia are therefore often based on guesswork, and non-demented patients may be rated as cognitively impaired in error. A randomly selected sample of 174 general practice patients aged 80 years and over were asked to complete a simple test of orientation and information in order to assess the usefulness and acceptability of such a procedure. If patients scored 10 points or less out of 12, a relative or other knowledgeable informant was questioned about their changes in mental state and behaviour. Assessments proved acceptable to patients, relatives and doctors; diagnoses were revised in 29 cases; and practical initiatives were proposed in 15 cases. Open discussions with patients and their families proved innocuous and have much to commend them.
全科医生常常不愿进行简短的认知测试，也不愿询问那些看似患有痴呆症患者的亲属，因为担心会引起痛苦。因此，痴呆症的诊断往往基于猜测，非痴呆患者可能会被错误地评定为认知受损。我们随机抽取了174名80岁及以上的全科门诊患者，要求他们完成一项简单的定向和信息测试，以评估这种程序的实用性和可接受性。如果患者在12分中得分10分或以下，就会询问其亲属或其他知情者其精神状态和行为的变化。评估结果证明患者、亲属和医生都能接受；29例诊断结果得到修正；15例提出了实际的应对措施。与患者及其家属进行公开讨论证明并无不良影响，且有诸多可取之处。
