SELF-REPORTS AND GENERAL-PRACTITIONER INFORMATION ON THE PRESENCE OF CHRONIC DISEASES IN COMMUNITY-DWELLING ELDERLY - A STUDY ON THE ACCURACY OF PATIENTS SELF-REPORTS AND ON DETERMINANTS OF INACCURACY

Object. The abject of the study is to investigate the (in)accuracy of patients' self-reports, as compared with general practitioners' inform ation, regarding the presence of specific chronic diseases, and the in fluence of patient characteristics. Methods. Questionnaire data of 238 0 community dwelling elderly patients, aged 55-85 years, on the presen ce of chronic non-specific lung disease, cardiac disease, peripheral a therosclerosis, stroke, diabetes, malignancies, and osteoarthritis/rhe umatoid arthritis were compared with data from the general practitione rs, using the kappa-statistic. Associations between the accuracy of se lf-reports and patient characteristics were studied by multiple logist ic regression analyses. Results. Kappa's ranged from 0.30 to 0.40 for osteoarthritis/rheumatoid arthritis and atherosclerosis, to 0.85 for d iabetes mellitus. In the multivariate analyses, educational level, lev el of urbanization, deviations in cognitive function, and depressive s ymptomatology had no influence on the level of accuracy, An influence of gender, age, mobility limitations, and recent contact with the gene ral practitioner was shown for specific diseases. For chronic non spec ific lung disease, both ''underreporting'' and ''overreporttng'' are m ore prevalent in males, compared to females. Furthermore, males tend t o overreport stroke and underreport malignancies and arthritis, wherea s females tend to overreport malignancies and arthritis. Both overrepo rting and underreporting of cardiac disease are more prevalent as peop le are older. Also, older age is associated with overreporting of stro ke, and with underreporting of arthritis. The self-reported presence o f mobility limitations is associated with overreporting of all specifi c diseases studied, except for diabetes mellitus, and its absence is a ssociated with underreporting, except for diabetes mellitus and athero sclerosis. Recent contact with the general practitioner is associated with overreporting of cardiac disease, atherosclerosis, malignancies a nd arthritis, and with less frequent underreporting of diabetes and ar thritis. Conclusions, Results suggest that patients' self-reports on s elected chronic diseases are fairly accurate, with the exceptions of a therosclerosis and arthritis. The associations found with certain pati ent characteristics may be explained by the tendency of patients to la bel symptoms, denial by the patient, or inaccuracy of medical records. Copyright (C) 1996 Elsevier Science Inc.