• Scott T Wilber, Samuel D Lofgren, Thomas G Mager, Michelle Blanda, and Lowell W Gerson.
• Department of Emergency Medicine, Summa Health System, Northeastern Ohio Universities College of Medicine, Akron, USA. wilbers@summa-health.org <wilbers@summa-health.org>
• Acad Emerg Med. 2005 Jul 1;12(7):612-6.

ObjectivesScreening for cognitive impairment in older emergency department (ED) patients is recommended to ensure quality care. The Mini-Mental State Examination (MMSE) may be too long for routine ED use. Briefer alternatives include the Six-Item Screener (SIS) and the Mini-Cog. The objective of this study was to describe the test characteristics of the SIS and the Mini-Cog compared with the MMSE when administered to older ED patients.MethodsThis institutional review board-approved, prospective, randomized study was performed in a university-affiliated teaching hospital ED. Eligible patients were 65 years and older and able to communicate in English. Patients who were unable or unwilling to perform testing, who were medically unstable, or who received medications affecting their mental status were excluded. Patients were randomized to receive the SIS or the Mini-Cog by the treating emergency physician. Investigators administered the MMSE 30 minutes later. An SIS score of ResultsA total of 149 of 188 approached patients were enrolled; 74 received the SIS and 75 the Mini-Cog. Fifty-five percent were female, the average age was 75 years, and 23% had an MMSE score of ConclusionsThe SIS, using a cutoff of

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