title: Living Unnoticed: Cognitive Impairment in Older People with Multimorbidity.
abstract: OBJECTIVE
  To investigate the correlation between MMSE ≤ 23 and the presence of a diagnosis of dementia in the medical record in a population with multimorbidity.
  
  
  METHODS
  This cross-sectional study was part of the Ambulatory Geriatric Assessment - a Frailty Intervention Trial (AGe-FIT; N = 382). Participants were community dwelling, aged ≥ 75 years, had received inpatient hospital care at least three times during the past 12 months, and had three or more concomitant diagnoses according to the International Classification of Diseases, 10th revision.
  
  
  METHODS
  The Mini Mental State Examination (MMSE) was administered at baseline. Medical records of participants with MMSE scores < 24 were examined for the presence of dementia diagnoses and two years ahead.
  
  
  RESULTS
  Fifty-three (16%) of 337 participants with a measure of MMSE had a MMSE scores < 24. Six of these 53 (11%) participants had diagnoses of dementia (vascular dementia, n = 4; unspecified dementia, n = 1; Alzheimers disease, n = 1) according to medical records; 89% did not.
  
  
  CONCLUSIONS
  A MMSE-score < 24 is not well correlated to a diagnosis of dementia in the medical record in a population of elderly with multimorbidity. This could imply that cognitive decline and the diagnosis of dementia remain undetected in older people with multimorbidity. Proactive care of older people with multimorbidity should focus on cognitive decline to detect cognitive impairment and to provide necessary help and support to this very vulnerable group.
authors.affiliation: Anne W. Ekdahl, Department of Geriatric Medicine, Norrköping and Karolinska Institutet, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Sweden. E-mail: anne.ekdahl@ki.se.
authors.forename: A W
authors.initials: AW
authors.lastname: Ekdahl
authors.forename: E
authors.initials: E
authors.lastname: Odzakovic
authors.forename: I
authors.initials: I
authors.lastname: Hellström
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests