AI Article Synopsis
- A study validated the Ottawa 3DY Scale, a quick 4-question screening tool for cognitive impairment in older emergency department patients, comparing its effectiveness to the Animal Fluency Test.
- In a cohort of 238 patients aged 75 and older, the Ottawa 3DY Scale showed 93.8% sensitivity and 72.8% specificity, while the Animal Fluency Test had 90.6% sensitivity but only 39.3% specificity.
- The Ottawa 3DY Scale is recommended as an effective screening tool that could improve cognitive impairment assessments in older patients within emergency departments.
Article Abstract
Study Objective: Assessment of older emergency department (ED) patients with cognitive impairment is challenging because few tools exist that can be quickly administered by front-line practitioners. Our objective is to validate the Ottawa 3DY Scale, a 4-question screening tool for cognitive impairment, in older ED patients and compare its performance with that of the Animal Fluency Test.
Methods: We conducted a prospective cohort study in 2 EDs and enrolled a convenience sample of patients aged 75 years or older with no history of cognitive impairment. Eligible patients were assessed by geriatric emergency management nurses who administered the Mini-Mental State Examination, ordered with the Ottawa 3DY Scale questions first, followed by the Animal Fluency Test. Mini-Mental State Examination score less than 25 was our criterion standard for cognitive impairment.
Results: Study patients (N=238) had a mean age of 81.9 years and were 60.1% women, and 26.5% were admitted to the hospital. The Ottawa 3DY Scale and Mini-Mental State Examination were in agreement for 75.6% of cases, with a sensitivity of 93.8% (95% confidence interval [CI] 77.8% to 98.9%) and specificity of 72.8% (95% CI 66.1% to 78.7%). The Animal Fluency Test score less than 15 and Mini-Mental State Examination score were in agreement for 46.2% of cases, with sensitivity 90.6% (95% CI 73.8% to 97.5%) and specificity 39.3% (95% CI 32.7% to 46.4%).
Conclusion: Both the Ottawa 3DY Scale and the Animal Fluency Test demonstrated excellent sensitivity versus the Mini-Mental State Examination; however, the Animal Fluency Test exhibited poor specificity. The Ottawa 3DY Scale is an effective tool to screen for cognitive impairment in older ED patients, and its use may facilitate improved care in this vulnerable population.
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| http://dx.doi.org/10.1016/j.annemergmed.2015.09.008 | DOI Listing |
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