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Logo of bmcgeriBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Geriatrics
 
BMC Geriatr. 2012; 12: 47.
Published online Aug 24, 2012. doi:  10.1186/1471-2318-12-47
PMCID: PMC3492162
Cognitive impairment is undetected in medical inpatients: a study of mortality and recognition amongst healthcare professionals
Gustav Torisson,corresponding author1 Lennart Minthon,1 Lars Stavenow,2 and Elisabet Londos1
1Department of Clinical Sciences, Clinical Memory Research Unit, Lund University, Simrisbanvägen 14, SE-205 02 Malmö, Sweden
2Department of Emergency Medicine, Skåne University Hospital, SE-205 02 Malmö, Sweden
corresponding authorCorresponding author.
Gustav Torisson: gustav.torisson/at/med.lu.se; Lennart Minthon: Lennart.Minthon/at/skane.se; Lars Stavenow: Lars.Stavenow/at/skane.se; Elisabet Londos: Elisabet.Londos/at/skane.se
Received April 10, 2012; Accepted August 21, 2012.
Abstract
Background
Detecting cognitive impairment in medical inpatients is important due to its association with adverse outcomes. Our aim was to study recognition of cognitive impairment and its association with mortality.
Methods
200 inpatients aged over 60 years were recruited at the Department of General Internal Medicine at University Hospital MAS in Malmö, Sweden. The MMSE (Mini-Mental State Examination) and the CDT (Clock-Drawing Test) were performed and related to recognition rates by patients, staff physicians, nurses and informants. The impact of abnormal cognitive test results on mortality was studied using a multivariable Cox proportional hazards regression.
Results
55 patients (28%) had no cognitive impairment while 68 patients (34%) had 1 abnormal test result (on MMSE or CDT) and 77 patients (39%) had 2 abnormal test results. Recognition by healthcare professionals was 12% in the group with 1 abnormal test and 44-64% in the group with 2 abnormal test results. In our model, cognitive impairment predicted 12-month mortality with a hazard ratio (95% CI) of 2.86 (1.28-6.39) for the group with 1 abnormal cognitive test and 3.39 (1.54-7.45) for the group with 2 abnormal test results.
Conclusions
Cognitive impairment is frequent in medical inpatients and associated with increased mortality. Recognition rates of cognitive impairment need to be improved in hospitals.
Keywords: Cognitive impairment, Medical inpatients, Mortality
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