| Use of serial Mini-Mental State Examinations to diagnose and monitor delirium in elderly hospital patients. | |
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MedLine Citation:
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PMID: 15877566 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Shaun T O'Keeffe; Eamon C Mulkerrin; Kayser Nayeem; Matthew Varughese; Isweri Pillay |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of the American Geriatrics Society Volume: 53 ISSN: 0002-8614 ISO Abbreviation: J Am Geriatr Soc Publication Date: 2005 May |
Date Detail:
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Created Date: 2005-05-09 Completed Date: 2005-06-21 Revised Date: 2008-03-10 |
Medline Journal Info:
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Nlm Unique ID: 7503062 Medline TA: J Am Geriatr Soc Country: United States |
Other Details:
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Languages: eng Pagination: 867-70 Citation Subset: IM |
Affiliation:
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Department of Geriatric Medicine, Galway Regional Hospitals, Galway, Ireland. s.okeeffe@whb.ie |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged
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psychology Delirium / diagnosis* Geriatric Assessment / methods* Hospitalization* Humans Mental Status Schedule Prospective Studies Sensitivity and Specificity |
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