An evaluation of two screening tools for cognitive impairment in older emergency department patients

Title

An evaluation of two screening tools for cognitive impairment in older emergency department patients

Creator

Wilber S T; Lofgren S D; Mager T G; Blanda M; Gerson L W

Publisher

Academic Emergency Medicine

Date

2005
2005-07

Description

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.

Subject

cognitive impairment; delirium; elderly emergency; Emergency department; Emergency Medicine; Examination; mental status; Mini-Cog; Mini-Mental State; prevalence; Six-Item Screener

Format

Journal Article

Search for Full-text

Users with a NEOMED Library login can search for full-text journal articles at the following url: https://libraryguides.neomed.edu/home

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

612-616

Issue

7

Volume

12

Citation

Wilber S T; Lofgren S D; Mager T G; Blanda M; Gerson L W, “An evaluation of two screening tools for cognitive impairment in older emergency department patients,” NEOMED Bibliography Database, accessed March 7, 2021, https://neomed.omeka.net/items/show/7584.

Social Bookmarking