title: Which mini-mental state exam items can be used to screen for delirium and cognitive impairment?
abstract: Cognitive impairment is common in palliative care patients, but it is frequently undetected. The clinical consequence is that psychiatric states such as delirium, which often present with cognitive impairment, are inadequately treated. A short and simple questionnaire for screening of cognitive impairment is required for these patients, in order to proceed with more advanced testing if necessary. In this study, we explored the results from two samples of patients (n=290 and n=217) who had completed the Mini-Mental State Examination (MMSE). Cases of cognitive impairment are considered indicated by an MMSE score of less than 24 of the total 30. We found that caseness could be fairly accurately screened by using four of the original 20 MMSE items, and that a six-item questionnaire further greatly improved the discrimination.
authors.affiliation: Department of Public Health, University of Aberdeen, Aberdeen, Scotland, UK.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Fayers
authors.forename: Marianne J
authors.initials: MJ
authors.lastname: Hjermstad
authors.forename: Anette H
authors.initials: AH
authors.lastname: Ranhoff
authors.forename: Stein
authors.initials: S
authors.lastname: Kaasa
authors.forename: Laila
authors.initials: L
authors.lastname: Skogstad
authors.forename: Pål
authors.initials: P
authors.lastname: Klepstad
authors.forename: Jon H
authors.initials: JH
authors.lastname: Loge
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D003693:Delirium / Q000175:diagnosis* / Q000453:epidemiology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008609:Mental Status Schedule; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires