Data from: Brief in-hospital cognitive screening anticipates complex admissions and may detect dementia

Objective: With the long-term goal of improving community health by
screening for dementia, we tested the utility of integrating the Six-Item
Screener (SIS) into our emergency department neurology consultations.
Methods: In this cross-sectional observational study, we measured SIS
performance within 24 hours of hospital arrival in 100 consecutive
English-speaking patients aged ≥ 45 years. Performance was compared to
patient age, previously charted cognitive impairment, and proxies for
in-hospital complexity: whether or not a patient was admitted to the
hospital and the number of medical studies ordered. Results: Those with
poor SIS performance were older (p = 0.02) and more likely to
have previously charted cognitive impairment (p < 0.01; sensitivity
86%, specificity 77%). Poor performers were more likely to be admitted to
the hospital (p = 0.04; odds ratio 3.6) and were subjected to more tests
once admitted (p < 0.01), relationships that persisted after
accounting for age and history of cognitive impairment. Conclusions: Poor
performance on the SIS was associated with previously charted cognitive
impairment, justifying future study of its ability to detect unrecognized
dementia cases. Until then, its ability to inexpensively anticipate
medically complex hospital admissions motivates broader emergency
department use of the SIS.