Document Detail

Use of serial Mini-Mental State Examinations to diagnose and monitor delirium in elderly hospital patients.
MedLine Citation:
PMID:  15877566     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To determine the responsiveness of serial Mini-Mental State Examinations (MMSEs) for the diagnosis and monitoring of delirium in elderly hospital patients. DESIGN: Prospective study. SETTING: University teaching hospital. PARTICIPANTS: One hundred sixty-five people admitted to an acute geriatric service. MEASUREMENTS: Subjects were assessed using the MMSE and the Confusion Assessment Method on hospital Days 1 and 6. Changes in scores were compared between patients who remained free of delirium (n=124) and those who by Day 6 had developed delirium (n=14) or had resolution of delirium present on admission (n=22). RESULTS: A number of measures of responsiveness confirmed that serial MMSE scores were responsive to resolution and to development of delirium. A fall of 2 or more points on the MMSE was the best determinant for detecting development of delirium (93% sensitivity, 90% specificity, positive likelihood ratio (LR)=8.9 (95% confidence interval (CI)=5.2-15.1) and negative LR=0.08 95% CI=0.01-0.53)). A rise of 3 or more points was the best determinant for detecting resolution of delirium (77% sensitivity, 75% specificity, positive LR=3.1 (95% CI=2.1-4.5) and negative LR=0.30 (95% CI=0.14-0.66)). CONCLUSION: The MMSE is responsive to short-term changes in cognitive function in elderly patients. Serial MMSE tests should be helpful in monitoring the development and resolution of delirium in this population.
Shaun T O'Keeffe; Eamon C Mulkerrin; Kayser Nayeem; Matthew Varughese; Isweri Pillay
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  53     ISSN:  0002-8614     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-05-09     Completed Date:  2005-06-21     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  867-70     Citation Subset:  IM    
Department of Geriatric Medicine, Galway Regional Hospitals, Galway, Ireland.
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MeSH Terms
Aged / psychology
Delirium / diagnosis*
Geriatric Assessment / methods*
Mental Status Schedule
Prospective Studies
Sensitivity and Specificity

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