Cognitive Dysfunction Among Emergency Department Patients Over the Age of 50 Years

Year 2021, Volume: 7 Issue: 2, 258 - 267, 12.07.2021

Levent Kuşoğlu Cem Oktay , Özlem Yiğit

https://doi.org/10.53394/akd.958952

Abstract

Objective: The aim of this study is to determine the prevalence of cognitive dysfunction among the patients over the age of 50 years who present to the emergency department.
Material and Methods: This cross-sectional study was carried out in the Emergency Department of Akdeniz University Hospital. In a 24-day period, all patients over the age of 50 years who presented to emergency department on weekdays between 08:00 and 18:00 were included in the study. Mini-Mental State Examination (MMSE) was applied to determine the cognitive dycfunction of the patients and threshold score was used as 23/24.
Results: Data of 298 patients were analysed. According to threshold score, cognitive dysfunction was detected in 53.7% of patients. Mild cognitive dycfunction (MMSE: 18-23) was detected in 47.3% of patients. MMSE scores decreaed with advancing age. A significant difference was found between education levels and MMSE scores; MMSE scores decreased as the level of education decreased. MMSE scores of female patients were detected to be significantly lower compared to male patients however significance was detected to arise from the lower education level of female patients.
Conclusion: MMSE scores are significantly affected by age and the level of education of patients over 50 years of age. In order to detect cognitive disorders in the early stage and to make appropriate referrals, it is necessary to conduct the validity and reliability study of MMSE in the emergency department setting.

Keywords

Cognitive dysfunctions, Geriatrics, Dementia, Emergency medicine

Acil Servise Başvuran 50 Yaş ve Üzeri Hastalarda Bilişsel Fonksiyon Bozukluğu

Abstract

Amaç: Bu çalışmanın amacı acil servise başvuran 50 yaş ve üzeri hasta grubunda bilişsel fonksiyon bozukluğunun sıklığını saptamaktır.
Gereç ve Yöntemler: Bu kesitsel çalışma Akdeniz Üniversitesi Hastanesi Acil Servisi’nde yapıldı. 24 günlük bir dönem içinde, hafta içi günlerde 08:00 - 18:00 saatleri arasında acil servise başvuran 50 yaş ve üzerindeki tüm hastalar çalışmaya dâhil edildi. Hastaların bilişsel fonksiyon bozukluğunun tespit edilmesi için Mini-Mental Durum Testi (MMDT) uygulandı ve eşik skor 23/24 olarak kullanıldı.
Bulgular: Toplam 298 hastanın verileri analiz edildi. Eşik skora göre hastaların %53,7’sinde bilişsel fonksiyon bozukluğu olduğu saptandı. Hafif bilişsel bozukluk (MMDT: 18-23) hastaların %47,3’ünde tespit edildi. İlerleyen yaşla birlikte MMDT skorlarının azaldığı belirlendi. Eğitim düzeyleri ile MMDT skorları arasında anlamlı bir farklılık bulundu; eğitim düzeyi azaldıkça MMDT skorlarının azaldığı belirlendi. Kadın hastaların MMDT skorlarının erkek hastalara oranla anlamlı şekilde düşük olduğu tespit edildi, ancak anlamlılığın kadın hastaların eğitim düzeyinin düşük olmasından kaynaklandığı saptandı.
Sonuç: MMDT skorları 50 yaş üstü hastalarda, yaş ve eğitim düzeyinden belirgin şekilde etkilenmektedir. Bilişsel bozuklukların erken dönemde tespit edilebilmesi ve uygun yönlendirmelerin yapılması için MMDT’nin acil servis koşullarındaki geçerlik ve güvenilirlik çalışmasının yapılması gerekmektedir.

Keywords

Biliş bozuklukları, Geriyatri, Demans, Acil tıp

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