Cognitive assessment of older adults at the acute care interface: the informant history

Postgraduate Medical Journal
Adam H DyerSean P Kennelly

Abstract

An informant history is critical in the complete cognitive assessments of older adults, but has never been formally assessed. A convenience sample of older adults aged ≥70 years were assessed using cognitive screeners for delirium (confusion assessment method-intensive care unit) and dementia (standardised Mini Mental State Examination and AD8) in a tertiary referral emergency department (ED). A total of 220/270 (81.5%) adults were included in the study (mean age 78.8±6.16; 49.1% male). Informant histories, obtained in almost two-thirds (61.1%, 66/108) of patients where desired, revealed a cognitive pattern suggestive of previously undiagnosed dementia in 39.4% (26/66). Most informants were relatives/friends (93.9%, 62/66) and were rated very good/excellent in contribution to care (96.9%, 64/66) and ability to provide useful information (93.9%, 62/66). The acute environment was also rated suitable to brief informant interviewing (mean duration <6 min) in terms of privacy (8.4±1.6/10) and accessibility (8.5±1.47/10). Following a review of the attending ED physician's notes, an informant history (either obtained/desired/refused) was only documented in 5.6% of cases. The informant history represents a much underused tool in the co...Continue Reading

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Citations

Dec 5, 2017·Irish Journal of Medical Science·Adam H DyerSean P Kennelly
Apr 27, 2019·Journal of Gerontological Nursing·Mu-Hsing HoMegan F Liu
Dec 4, 2019·Medizinische Klinik, Intensivmedizin und Notfallmedizin·C J van BeekumT O Vilz

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