Screening for dementia and delirium using an adapted Folstein Mini-Mental State Examination

An adapted Folstein Mini-Mental State Examination was applied to 244 consecutive admissions to an acute geriatric medical unit to determine the prevalence of cognitive impairment. At a cut-off point of 23/30, 109 (44%) were rated as normal and 44 (19%) were unable to perform the test. Of the 85 (36%) who scored less than 23, 63 were suffering from dementia, nine were delirious, and 12 had normal cognitive function, a false positive rate of 14%. The most common dementia was senile dementia of the Alzheimer type. Cognitive impairment was not noted by the admitting doctor in 57% of affected cases. The need for increased awareness of cognitive impairment in the elderly is emphasized, and the more widespread use of formal mental test scores is recommended.