title: The impact of dementia on the use of general practitioners among the elderly in Norway.
abstract: OBJECTIVE
  To assess the use of general practitioners (GPs), in elderly home-dwelling persons in Norway and explore the impact of cognitive decline, age, and living situation.
  
  
  METHODS
  Prospective longitudinal study.
  
  
  METHODS
  Data were collected from municipalities in four counties in Norway in the period from January 2009 to August 2012.
  
  
  METHODS
  Home-dwelling persons 70 years of age or older, receiving in-home care.
  
  
  METHODS
  Use of GPs over a period of 18 months related to cognitive state, functional status, neuropsychiatric symptoms, and demographics.
  
  
  RESULTS
  A total of 599 persons were included. The mean annual number of consultations per participant was 5.6 (SD = 5.4). People with moderate to severe dementia had fewer consultations per year compared with those with mild or no dementia (3.7 versus 5.8 per year, p = 0.004). In the multivariate model higher age predicted fewer consultations while affective neuropsychiatric symptoms were associated with an increase in frequency of consultations. The most frequent reason to consult a GP was cardiovascular diseases (36.8% of all consultations), followed by musculoskeletal complaints (12.1%) and psychiatric diagnoses (8.7%).
  
  
  CONCLUSIONS
  Our study shows that the home-dwelling elderly with moderate to severe dementia in Norway consult their GP less often than persons with mild or no dementia. This could indicate a need for better interaction between the municipal care and social services and the general practitioners.
authors: a Centre for Age-related Medicine, Stavanger University Hospital , Norway.|b Centre for Development of Institutional and Home Care Services Rogaland , Norway.|c Centre for Old Age Psychiatry Research, Innlandet Hospital Trust , Norway.
authors: A E
authors: AE
authors: Ydstebø
authors: c Centre for Old Age Psychiatry Research, Innlandet Hospital Trust , Norway.
authors: S
authors: S
authors: Bergh
authors: c Centre for Old Age Psychiatry Research, Innlandet Hospital Trust , Norway.|d Helse Sør-Øst Health Services Research Centre, Akershus University Hospital , Norway.|f Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust , Tønsberg , Norway.
authors: G
authors: G
authors: Selbæk
authors: c Centre for Old Age Psychiatry Research, Innlandet Hospital Trust , Norway.|d Helse Sør-Øst Health Services Research Centre, Akershus University Hospital , Norway.|e Institute of Clinical Medicine, University of Oslo.
authors: J Šaltytė
authors: JŠ
authors: Benth
authors: d Helse Sør-Øst Health Services Research Centre, Akershus University Hospital , Norway.|e Institute of Clinical Medicine, University of Oslo.
authors: H
authors: H
authors: Lurås
authors: a Centre for Age-related Medicine, Stavanger University Hospital , Norway.|b Centre for Development of Institutional and Home Care Services Rogaland , Norway.
authors: C
authors: C
authors: Vossius
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000628:therapy; D005260:Female; D058006:General Practice; D058005:General Practitioners; D006301:Health Services Needs and Demand; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006699:Home Care Services; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009042:Motivation; D009664:Norway; D010342:Patient Acceptance of Health Care; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D012017:Referral and Consultation
keywords: Dementia; Norway; emergency service; general practice; general practitioner; municipal care