title: Dementia, diagnostic disclosure, and self-reported health status.
abstract: OBJECTIVE
  To investigate the general awareness of cognitive impairment in persons with documented dementia, evaluate the subject's recall of a diagnostic disclosure from a physician and their recollection of the discussion, and determine whether this awareness of cognitive impairment or the recall of diagnostic disclosure is associated with poorer self-rated health scores.
  
  
  METHODS
  Secondary data analysis.
  
  
  METHODS
  Three university-based clinical referral sites for dementia illnesses.
  
  
  METHODS
  Convenience sample of 149 patients with a diagnosis of dementia.
  
  
  METHODS
  Bivariate and logistic regression models with the outcome variables of patient self-report of memory problems, patient report of being told about memory problems by a physician, and self-reported health scores.
  
  
  RESULTS
  Ninety-six of 149 (64.4%) subjects reported that they had memory problems, and this report was independently associated with younger age (P=.01) and higher Mini-Mental State Examination score (P=.02). Thirty-nine (26.2%) subjects reported being told by a physician about a diagnosis of dementia or memory problems. This recall was associated with younger age (P<.001), male sex (P=.04), and higher education level (P=.02). African Americans reported poorer self-rated health scores (odds ratio (OR)=2.4, 95% confidence interval (CI)=1.1-5.1). Persons who reported being told by a physician of a diagnosis of dementia were more likely to report poorer self-rated health (OR=2.5, 95% CI 1.1-5.5).
  
  
  CONCLUSIONS
  Further research is needed to elucidate the relationship between self-rated health and dementia specifically focusing on the potentially negative effects of diagnostic disclosure on self-rated health, further identification of factors that contribute to self-rated health in persons with dementia, and the prognostic value of self-rated health for persons with dementia.
authors.affiliation: Section of Geriatrics, University of Chicago, Chicago, Illinois 60637, USA. kcampbel@medicine.bsd.uchicago.edu
authors.forename: Kellie H
authors.initials: KH
authors.lastname: Campbell
authors.forename: Carol B
authors.initials: CB
authors.lastname: Stocking
authors.forename: Gavin W
authors.initials: GW
authors.lastname: Hougham
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Whitehouse
authors.forename: Deborah D
authors.initials: DD
authors.lastname: Danner
authors.forename: Greg A
authors.initials: GA
authors.lastname: Sachs
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001364:Awareness; D016009:Chi-Square Distribution; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008569:Memory Disorders / Q000523:psychology*; D011939:Mental Recall; D008609:Mental Status Schedule; D010817:Physician-Patient Relations; D012650:Self Disclosure