Cognitive impairment in elderly ED patients: need for multidimensional assessment for better management after discharge.

We describe the prevalence of cognitive impairment in a population aged 65 and older requiring urgent medical services and to propose global evaluation, involving cognitive, functional and social aspects, during the emergency department (ED) visit to define an individualized care protocol. A total of 150 patients aged 65 and older attended at the ED were screened for cognitive impairment using the Mini-Mental State Examination (MMSE). Patients with an MMSE score lower or equal to 23 were included in the second step of the study, namely evaluation involving neuropsychological instruments to assess cognitive and functional status and a questionnaire exploring socioeconomic conditions and type of support need. Cognitive impairment was detected in 24 patients (16%). In no case of mild impairment had a cognitive deficit already been diagnosed. The functional and socioeconomic profile enabled proposing a strategy for better management of the patients discharged by the ED. Copyright 2002, Elsevier Science (USA). All rights reserved.)