Mild cognitive impairment in medical inpatients: the Mini-Mental State Examination is a promising screening tool.
OBJECTIVE
To assess the prevalence of mild cognitive impairment (MCI) in medical inpatients aged 55-85 years without known cognitive deficits, and how often ward physicians mentioned MCI in their discharge notes. Moreover, we aimed to identify variables associated with MCI and to assess the sensitivity and specificity of the Mini-Mental State Examination (MMSE) for MCI.


METHODS
Two neuropsychologists administered a 60-min battery of validated tests to evaluate different cognitive domains. The diagnosis of MCI was based on a prespecified algorithm. The sensitivity and specificity of the MMSE for MCI were calculated.


RESULTS
Fifteen patients showed a normal cognitive profile (21.4%), while 55 patients (78.6%) showed MCI. Ward physicians, blinded to the results of the neuropsychological evaluation, did not mention MCI in their discharge notes of any of the evaluated patients. The only variable independently associated with MCI was the MMSE. A MMSE score of < or =28 showed a sensitivity of 85.5% and a specificity of 66.7% for MCI.


CONCLUSIONS
MCI is frequent albeit overlooked in elderly medical inpatients without previously known cognitive deficits. In view of therapies preventing the progression of MCI to dementia, MCI screening will be crucial. The MMSE represents a promising screening tool for MCI in medical inpatients.
De Marchis
G M
GM
Department of Internal Medicine, Ospedale La Carità, Locarno, Switzerland. gian-marco.demarchis@insel.ch
Foderaro
G
G
Jemora
J
J
Zanchi
F
F
Altobianchi
A
A
Biglia
E
E
Conti
F M
FM
Monotti
R
R
Mombelli
G
G
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D004493:Education; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D016017:Odds Ratio; D012307:Risk Factors; D013557:Switzerland / Q000453:epidemiology