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Mini-Mental Status Exam (mini-mental status + exam)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

No association between subjective memory complaints and apolipoprotein E genotype in cognitively intact elderly

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 12 2004
Dylan G. Harwood
Abstract Objective This cross-sectional study examined the relationship between subjective memory complaints and the apolipoprotein epsilon 4 allele (,4), a genetic risk factor for Alzheimer's disease (AD), among cognitively normal subjects identified from a community memory screening. Design The sample comprised 232 consecutive white non-Hispanic older adults who presented to a free community-based memory-screening program at a University affiliated memory disorders center. Participants were classified as cognitively normal based on scores on the age and educated adjusted Folstein Mini-Mental Status Exam (MMSAdj) and a brief Delayed Verbal Recall Test (DRT). Subjects were assessed for APOE genotype, subjective memory complaints (Memory Questionnaire, MQ), depressive symptoms (Hamilton Depression Rating Scale, HDRS), and history of four major medical conditions that have been associated with memory loss (stroke/transient ischemic attack [TIA], atherosclerotic heart disease, hypertension, and diabetes). A hierarchical regression analysis was performed to examine the association between APOE genotype and memory complaints after controlling for a host of potential confounding factors. Results The APOE ,4 allele frequency for cognitively normal subjects was 0.13. Subjective memory complaints were predicted by depressive symptoms and a history of stroke/TIA. They were not associated with APOE genotype, MMSAdj score, DRT score, age, education, gender, and reported history of atherosclerotic heart disease, hypertension, or diabetes. Conclusion The results did not suggest an association between subjective memory complaints and the APOE ,4 allele in this sample of cognitively intact subjects. This indicates that memory complaints may confer risk for future dementia through pathways independent of APOE genotype. The results also show that older adults with memory complaints are at increased risk for underlying depression. Copyright © 2004 John Wiley & Sons, Ltd. [source]

Predicting post-operative delirium in elderly patients undergoing surgery for hip fracture

PSYCHOGERIATRICS, Issue 2 2006
Gregory GOLDENBERG
Abstract Background:, Delirium in elderly patients with hip fracture has a significant negative influence on the disease course. Awareness of risk factors for postoperative delirium (POD) may lead to the development of effective preventive strategies. The aims of this study were: to find patients' features that are predictors of POD, and; to develop a model predicting the risk for POD. Patients and methods:, Seventy-seven elderly patients (81.9 years of age, SD 7.5 years) were non-delirious prior to surgery and enrolled in the study. Delirium was diagnosed by Confusion Assessment Method and Algorrhithm. Patients' characteristics as potential predictors of POD were analyzed by logistic regression analysis on SAS software. Results:, Postoperative delirium was diagnosed in 37 patients. Use of multiple (>3) medications, lower scores on cognitive tests (<20 on Set Test and <24 on Mini-mental Status Exam), albumin level less than 3.5 g/dL, hematocrit level less than 33% and age over 81 years were predictors of POD. A logistic regression formula including these predictors weighed by their parameter estimates can be used to calculate the probability of POD. The model had a good fit and a good predictive power. A Delirium Predicting Scale was derived based on parameter estimates of these predictors. Patients can be classified as low-, intermediate- or high-risk for POD. Conclusions:, A logistic regression model, which includes patients' age, medication history, cognitive performance measured by Set Test and Mini-Mental Status Exam, albumin and hematocrit levels, can be used to predict risk for POD after surgical repair of fractured hip in elderly patients. [source]

Blood Pressure Response to the ImpedanceThreshold Device in Hypotensive Emergency Department Patients

ACADEMIC EMERGENCY MEDICINE, Issue 2008
Samuel Luber
Background:, An impedance threshold device (ITD) has been found to enhance circulation during CPR by increasing cardiac preload. Additionally, in the spontaneously breathing patient, the ITD has been found to create a small degree of inspiratory resistance (-6 cm H2O at flow rate of 20L/min). Hypothesis: We sought to determine the effects of the ITD on awake patients with hypotension presenting to the emergency department. We hypothesized that the ITD would improve blood pressure when compared to standard therapy. The main outcome measure was the systolic blood pressure (SBP) change during 10 minutes of ITD use. Methods:, A convenience sample of patients with SBPs <95 mmHg were randomized in double-blind fashion to active or sham ITDs. Patients were enrolled if they were between the ages of 18 and 70 and their hypotension was felt to be due to non-traumatic blood loss or dehydration by the treating physician. Patients were excluded if they were experiencing shortness of breath, chest pain, failed the abbreviated mini-mental status exam, or had predefined cardiac/pulmonary history criteria. After consent and baseline measurements, patients spontaneously breathed through a mouthpiece attached to an active or sham ITD for a 10 minute period during which vital signs and patient status were recorded. Results:, 12 patients were enrolled (5 randomized to the active device, 7 to the sham device). Mean baseline SBPs were similar between groups with the active and sham devices having baseline SBPs of 84.5 mmHg (SD 5.45) and 83.67 mmHg (SD 10.02), respectively. The active ITD produced a statistically significant (p = 0.03) increase in SBP of 13.0 mmHg (SD 4.69) compared to the sham ITD, 2.33 mmHg (SD 0.58). Conclusions:, In spontaneously breathing hypotensive ED patients, the ITD was well-tolerated and increased the SBP. If these results are validated with a larger sample, the ITD may be a useful adjunct in the treatment of hypotension due to volume loss in the ED. [source]