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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- The Independent Hospital Pricing Authority (IHPA) has purchased the Australian intellectual property rights of the SMMSE and has granted permission for all health care facilities and aged care services throughout Australia to freely use the SMMSE (copyright issues are associated with use of the MMSE).
Reviewed 18 October 2024