The Six-Item Screener and AD8 for the detection of cognitive impairment in geriatric emergency department patients.
OBJECTIVE
We evaluate the diagnostic test characteristics of the Six-Item Screener and the AD8 to detect cognitive dysfunction in adults older than 65 years and using the emergency department (ED) for any reason.


METHODS
We conducted an observational cross-sectional cohort study at a single academic urban university-affiliated hospital. Subjects were consenting, non--critically ill, English-speaking adults older than 65 years and receiving care in the ED. We quantitatively assessed the diagnostic test characteristics of the Six-Item Screener and AD8 by using the Mini-Mental State Examination score less than 24 as the criterion standard for cognitive dysfunction.


RESULTS
The prevalence of cognitive dysfunction was 35%, but only 6% of charts noted a pre-existing deficit. The Six-Item Screener was superior to either the caregiver-administered AD8 or the patient-administered AD8 for the detection of cognitive dysfunction.


CONCLUSIONS
The Six-Item Screener was superior to the caregiver- or patient-administered AD8 to identify older adults at increased risk for occult cognitive dysfunction.
Carpenter
Christopher R
CR
Division of Emergency Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO, USA. carpenterc@wusm.wustl.edu
DesPain
Bobby
B
Keeling
Travis N
TN
Shah
Mansi
M
Rothenberger
Morgan
M
D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity