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Text
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<a href="http://doi.org/10.1111/j.1553-2712.2005.tb00915.x" target="_blank" rel="noreferrer noopener">http://doi.org/10.1111/j.1553-2712.2005.tb00915.x</a>
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Pages
612-616
Issue
7
Volume
12
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Title
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An evaluation of two screening tools for cognitive impairment in older emergency department patients
Publisher
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Academic Emergency Medicine
Date
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2005
2005-07
Subject
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cognitive impairment; delirium; elderly emergency; Emergency department; Emergency Medicine; Examination; mental status; Mini-Cog; Mini-Mental State; prevalence; Six-Item Screener
Creator
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Wilber S T; Lofgren S D; Mager T G; Blanda M; Gerson L W
Description
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Objectives: Screening for cognitive impairment in older emergency department (ED) patients is recommended to ensure quality care. The Mini-Mental State Examination (MMSE) may be too long for routine ED use. Briefer alternatives include the Six-Item Screener (SIS) and the Mini-Cog. The objective of this study was to describe the test characteristics of the SIS and the Mini-Cog compared with the MMSE when administered to older ED patients. Methods: This institutional review board-approved, prospective, randomized study was performed in a university-affiliated teaching hospital ED. Eligible patients were 65 years and older and able to communicate in English. Patients who were unable or unwilling to perform testing, who were medically unstable, or who received medications affecting their mental status were excluded. Patients were randomized to receive the SIS or the Mini-Cog by the treating emergency physician. Investigators administered the MMSE 30 minutes later. An SIS score of <= 4, the Mini-Cog's scoring algorithm, and an MMSE score of <= 23 defined cognitive impairment. Results: A total of 149 of 188 approached patients were enrolled; 74 received the SIS and 75 the Mini-Cog. Fifty-five percent were female, the average age was 75 years, and 23% had an MMSE score of <= 23. The SIS had a sensitivity of 94% (95% confidence interval [CI] = 73% to 100%) and a specificity of 86% (95% CI = 74% to 94%). The Mini-Cog had a sensitivity of 75% (95% CI = 48% to 93%) and a specificity of 85% (95% CI = 73% to 93%). Conclusions: The SIS, using a cutoff of <= 4 as impaired, is a promising test for ED use. It is short, easy to administer, and unobtrusive, allowing it to be easily incorporated into the initial assessment of older ED patients.
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<a href="http://doi.org/10.1111/j.1553-2712.2005.tb00915.x" target="_blank" rel="noreferrer noopener">10.1111/j.1553-2712.2005.tb00915.x</a>
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Journal Article
2005
Academic Emergency Medicine
Blanda M
cognitive impairment
delirium
elderly emergency
Emergency department
Emergency Medicine
examination
Gerson L W
Journal Article
Lofgren S D
Mager T G
Mental Status
Mini-Cog
Mini-Mental State
Prevalence
Six-Item Screener
Wilber S T