A clinical comparison of tests of organicity in elderly patients.

The quantification and standardization of observations of clinically significant organicity in the elderly is possible through the administration of specific cognitive tests. In this study, four organicity tests were evaluated on a geriatric medical/surgical patient group, with the SPMSQ yielding the best correlation with a clinical diagnosis of organicity. The SPMSQ is also recommended for its ease of administration, brevity, quantitative output, and straight-forward interpretation. The FHT produces an increment of improvement in the identification of organic groups, thus serving as a useful second test. The MSQ, while longer and slightly more complex, is roughly equivalent to the SPMSQ. The MFD test, the most lengthy and complex of the four instruments used, did not add sufficient additional information for this sample to warrant its inclusion in a testing regimen. Accurate diagnosis is critical for the geriatric patient if excessive morbidity and mortality are to be avoided, and unnecessarily long hospital stays are to be reduced. The availability of a short, easily administered test like the SPMSQ can effectively improve the assessment of the elderly patient at little additional cost to the clinician.