L. Dziedzic et al., THE USE OF THE MINI-MENTAL STATUS EXAMINATION IN THE ED EVALUATION OFTHE ELDERLY, The American journal of emergency medicine, 16(7), 1998, pp. 686-689
This study was done to examine the impact of the mini-mental status ex
amination (MMSE) in the emergency department (ED) evaluation of the el
derly patient. The study was a prospective study of the MMSE applied b
y the investigators with a comparison to the findings of the treating
physician, in a university hospital ED with annual volume of 60,000, P
articipants were a convenience sample of patients older than 65 years
of age without apparent mental status abnormality presenting to the ED
. Seventy four patients were entered in the study with 43 exclusions (
23 with low educational level, 5 with Glasgow Coma Scale score of <15,
and 15 other) leaving 31 cases for analysis. Of the 31 patients, 20 p
atients had an MMSE score of <24. The MMSE findings agreed with the tr
eating physicians' assessments in 21 (67%) cases. Disagreement occurre
d in 10 (32%) cases in which the treating physician believed that both
the patient's mental status and results of the investigator's MMSE we
re normal; these 10 cases all involved low MMSE scores as performed by
the investigator. When informed of the abnormal MMSE, both the physic
ian's estimate of the patient's mental status and the patient's ED cou
rse were altered in all cases. These results show that the MMSE is a v
aluable screening tool to assess the mental status of the elderly in t
he ED setting. Unexpected abnormality was noted in a significant minor
ity of patients in this study, altering the patient's course in all in
stances. The MMSE should be considered in evaluation of all geriatric
patients encountered in the ED. Copyright (C) 1998 by W.B. Saunders Co
mpany.