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White-coat effect among older patients with suspected cognitive impairment: prevalence and clinical implications
International journal of geriatric psychiatry, 2009-05, Vol.24 (5), p.509-517
Mario, Bo
Massimiliano, Massaia
Chiara, Merlo
Alessandro, Sona
Antonella, Canadè
Gianfranco, Fonte
2009
Details
Autor(en) / Beteiligte
Mario, Bo
Massimiliano, Massaia
Chiara, Merlo
Alessandro, Sona
Antonella, Canadè
Gianfranco, Fonte
Titel
White-coat effect among older patients with suspected cognitive impairment: prevalence and clinical implications
Ist Teil von
International journal of geriatric psychiatry, 2009-05, Vol.24 (5), p.509-517
Ort / Verlag
Chichester, UK: John Wiley & Sons, Ltd
Erscheinungsjahr
2009
Link zum Volltext
Quelle
MEDLINE
Beschreibungen/Notizen
Objectives To evaluate the prevalence of white‐coat effect (WCE), and its association with individual anxiety and insight of disease, among older patients evaluated for suspected cognitive impairment. Methods This prospective cohort study, conducted in an Alzheimer Evaluation Unit, involved patients aged 55 years or older with suspected cognitive impairment. WCE was defined as a difference of at least 20 mmHg in systolic or 10 mmHg in diastolic blood pressure (BP) measured either by a physician during the visit or by a nurse (before and after the visit), compared with home self‐blood pressure measurement (SBPM). Severity of cognitive impairment was evaluated through the Mini‐Mental State Examination (MMSE); the Clinical Insight Rating Scale (CIR) and the Guidelines for the Rating for Awareness Deficits (GRAD) were used to evaluate the subject's insight; anxiety disorder was evaluated using the seven‐question Generalized Anxiety Disorder scale (GAD‐7). Results Among 273 subjects, prevalence of WCE was 52%, 32.6% and 30.4%, according to physician and nurse BP measurements, respectively (p = 0.000). Prevalence of WCE did not differ between patients diagnosed with and without dementia, but was higher among patients with than in those without anxiety disorder (70.7% vs 38.2%, p = 0.000). Positive relations were observed between severity of anxiety and insight of disease, which were both inversely related with severity of coginitive impairment. Conclusions WCE is extremely common and is correlated to individual anxiety and insight of disease among older outpatients with suspected cognitive impairment; overestimation of hypertension severity might lead to unnecessary drug treatment and greater health costs in this setting. Copyright © 2008 John Wiley & Sons, Ltd.
Sprache
Englisch
Identifikatoren
ISSN: 0885-6230, 1099-1166
eISSN: 1099-1166
DOI: 10.1002/gps.2145
Titel-ID: cdi_proquest_miscellaneous_764384087
Format
–
Schlagworte
Aged
,
Aged, 80 and over
,
Anxieties
,
Anxiety Disorders - epidemiology
,
Arterial hypertension. Arterial hypotension
,
Attitude to Health
,
Biological and medical sciences
,
Blood and lymphatic vessels
,
Blood pressure
,
Blood Pressure Determination - methods
,
Blood Pressure Determination - nursing
,
Blood Pressure Determination - psychology
,
Cardiology. Vascular system
,
Clinical psychology
,
Cognition & reasoning
,
cognitive impairment
,
Dementia - epidemiology
,
Dementia - psychology
,
False Positive Reactions
,
Female
,
Geriatric Assessment
,
Geriatric psychology
,
Geriatrics
,
Humans
,
hypertension
,
Hypertension - epidemiology
,
Hypertension - psychology
,
isolated clinic hypertension
,
Male
,
Medical sciences
,
Mental health
,
Middle Aged
,
Older people
,
Prevalence
,
Prospective Studies
,
Psychology. Psychoanalysis. Psychiatry
,
Psychopathology. Psychiatry
,
Severity of Illness Index
,
white-coat effect
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