Cognitive screening, on admission to hospital and routinely throughout an older patient's hospital stay, is important to identify risk of functional decline and rule out possible treatable causes. It provides a baseline to identify a decline in cognition that may be due to delirium; depression or dementia. An improvement in a person’s test scores, once treatment has been administered, can help to confirm a diagnosis of delirium.
The most commonly used cognitive assessment tools in the hospital setting are:
- the Standardised Mini Mental-State Examination (SMMSE)1
- the Abbreviated Mental Test Score (AMTS)
- The Clock Drawing Test (CDT)
- 4AT
Two tools developed for use with people from culturally and linguistically diverse backgrounds are:
- Mini-Cog
- Rowland Universal Dementia Assessment Scale (RUDAS)
A tool developed specifically for indigenous Australians (remote and urban modified versions) is:
- Kimberley Indigenous Cognitive Assessment (KICA)
Informant-based questionnaires are completed by someone who knows the person being assessed well; they provide complementary information on a person’s cognitive status or can be used in situations where testing a person’s cognition is difficult due to illness, dysphasia or literacy deficit. They include:
- Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE)
Complete cognitive screening using one of the tools above before administering the Confusion Assessment Method (CAM) to identify delirium.
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