Related Experiment Video
Updated: Dec 6, 2025
08:47
Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
13.3K
Assessing the Reliability of Reported Medical History in Older Adults
Gregory S Day1, Allison Long1,2, John C Morris2,3
1Hendrix College, Conway, AR, USA.
Journal of Alzheimer'S Disease : JAD
|October 5, 2020
Summary
Older adults’ self-reported medical history, particularly stroke, often mismatches objective findings. Factors beyond age and cognitive impairment influence reporting accuracy, necessitating objective testing for critical health decisions.
Area of Science:
- Gerontology and Aging Research
- Neurology and Neuroimaging
- Endocrinology and Metabolic Disorders
Background:
- Aging is associated with increased medical complexity, frailty, and cognitive decline, potentially impairing accurate self-reporting of health history.
- Reliable medical history is crucial for accurate diagnosis and treatment, yet age-related factors may compromise its validity in older adults.
Purpose of the Study:
- To investigate how increasing age and cognitive impairment affect the accuracy of self-reported stroke and diabetes history in community-dwelling older adults.
- To determine the concordance between reported medical history and objective clinical/imaging data for stroke (cerebral infarction) and diabetes (hemoglobinA1c).
Main Methods:
- Utilized multivariable logistic regression to analyze data from 1,401 participants in longitudinal aging studies.
- Assessed stroke history against magnetic resonance neuroimaging for cerebral infarcts and diabetes history against hemoglobinA1c levels (≥6.5%).
- Included 425 participants with dementia (30.3%) to evaluate the impact of cognitive impairment on reporting accuracy.
Main Results:
- Concordance for stroke history was low (sensitivity: 17.4%), with small, silent cerebral infarcts strongly linked to inaccurate reporting (OR=265.8).
- Reporting accuracy for diabetes was higher (sensitivity: 83.5%), but hypertension, elevated hemoglobinA1c, and impaired glucose tolerance were associated with discordant reporting.
- Neither advanced age nor cognitive impairment independently correlated with unreliable self-reporting of stroke or diabetes history.
Conclusions:
- Factors other than age and cognitive impairment significantly influence discrepancies in medical history reporting among older adults.
- Objective diagnostic testing for conditions like cerebral infarction and diabetes is recommended in clinical and research settings when relevant for decision-making.
Related Concept Videos
01:29Data Collection II
9.5K
The nursing history captures and records the patient's health status, so that a care plan evolves to meet the patient's individual needs. The nursing health history is a part of the initial assessment. A comprehensive history covers all health dimensions and plays a significant role in the assessment process. A comprehensive history includes the patient's biographical information, reasons for seeking health care, expectations, present and past health history, medications, and...
9.5K
01:23Assessment of the Cardiovascular System I: Subjective Data
641
A thorough health history and physical assessment are essential for identifying cardiovascular disease (CVD) symptoms and distinguishing them from other health issues.
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
641
01:21Nursing Assessment of the Genitourinary System I: Health History
255
The genitourinary system is critical to maintaining fluid balance, waste elimination, and reproductive function. Nurses play a vital role in assessing this system, beginning with a thorough health history. This process involves gathering patient information, identifying risk factors, and recognizing symptoms of genitourinary disorders. Early detection is vital for timely interventions and management.1. Gathering Patient InformationA complete health history includes the patient’s personal,...
255
01:17Assessment of the Gastrointestinal System I: Subjective Data
512
Assessing the gastrointestinal (GI) system is a complex process that begins with collecting subjective data. This data, collected through patient interviews, provides crucial insights into the patient's health history, perception patterns, and lifestyle habits, all contributing significantly to GI health.
Health History
The initial step in assessing the GI system is obtaining a comprehensive health history. This includes inquiring about the patient's history or presence of problems...
Health History
The initial step in assessing the GI system is obtaining a comprehensive health history. This includes inquiring about the patient's history or presence of problems...
512
01:19Purpose of Health Records II
1.3K
Health records serve various essential purposes in the healthcare system. Here are some key purposes:
1.3K
01:15Drug Dosing: Geriatric Patients
128
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
128