title: "Alert and Oriented × 3?" Correlates of Mini-Cog Performance in a Post/Nondelirious Intensive Care Unit Sample.
abstract: BACKGROUND
  Cognitive impairment has been found to be a predictor of adverse medical outcomes, including nonadherence, recurrent medical crises resulting in early readmissions, and death.
  
  
  OBJECTIVE
  The Mini-Cog has been proposed for bedside/clinic cognitive testing. Its validity as a measure of central nervous system (CNS) impairment has never been tested against measures of CNS-medical history, CNS scans, selected laboratory findings, observed in-hospital nondelirious memory impairment, or collateral history from family.
  
  
  METHODS
  We observed Mini-Cog performance in 107 post/nondelirious medical intensive care unit patients and tested its association with age, CNS-medical history, CNS scans, selected laboratory findings, and behavioral history (in-hospital observation of memory problems and collateral history from family or significant others).
  
  
  RESULTS
  The overall Mini-Cog covaried with age, various measures of CNS impairment, abnormal laboratory findings, and measures of preadmission "forgetfulness" per family and by in-hospital staff observation. Unique variance in predicting overall Mini-Cog scores included age, positive CNS scan, and behavioral history. Of 91 patients found to be "alert and oriented × 3," 76% were impaired in immediate memory, short-term memory, or clock drawing.
  
  
  CONCLUSIONS
  The Mini-Cog appears to be a brief, yet valid, measure of CNS dysfunction that significantly enhances sensitivity of evaluation at the bedside. Failure to evaluate patients with a formal examination like the Mini-Cog appears to miss up to 76% of patients with moderate cognitive impairment.
authors.affiliation: Division of Consultation-Liaison Psychiatry & Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Wayne State University, Detroit, MI. Electronic address: MKetter1@hfhs.org.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Ketterer
authors.affiliation: Division of Consultation-Liaison Psychiatry & Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Wayne State University, Detroit, MI.
authors.forename: Yathreb
authors.initials: Y
authors.lastname: Alaali
authors.affiliation: Division of Consultation-Liaison Psychiatry & Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Wayne State University, Detroit, MI.
authors.forename: Lenar
authors.initials: L
authors.lastname: Yessayan
authors.affiliation: Division of Consultation-Liaison Psychiatry & Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Wayne State University, Detroit, MI.
authors.forename: Jeff
authors.initials: J
authors.lastname: Jennings
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008570:Memory, Short-Term; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D055815:Young Adult