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J Neuropsychiatry Clin Neurosci. 2010 Summer;22(3):329-37. doi: 10.1176/appi.neuropsych.22.3.329.

Relationship between cognitive status at admission and incident delirium in older medical inpatients.

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  • 1Calle San Antonio, Numero 10, 1o 2a, Postal Code 43201, Reus, Spain. josefranco11@hotmail.com


To evaluate the relationship between cognitive status and incident delirium, 291 geriatric patients on internal medicine wards were evaluated on admission with the Mini-Mental State Examination (MMSE) and Confusion Assessment Method-Spanish. Those with incident delirium were assessed using the Delirium Rating Scale-Revised-98 (DRS-R98). Delirium incidence was 11.7%, and 82 patients (28.2%) had cognitive deficits on MMSE. As cognitive impairment worsened, the risk for delirium increased linearly, and for each unit of MMSE worsening the DRS-R98 severity score worsened 0.4 points (F=5.39, df=1, p=0.027). Optimal MMSE cutoff score from receiver-operating characteristic curve analysis was 24.5. Even mild cognitive deficits increase delirium risk and severity.

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