Primary care
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Mental status testing is an essential element of evaluating elderly patients. A structured examination often helps identify the etiology of symptoms that are responsible for changes in patient behavior, that lead to family stress, but that are otherwise not indicative of cognitive dysfunction. ⋯ This article examines the steps in mental status assessment and the commonly used assessment instruments. The experience of a family medicine ambulatory multidisciplinary evaluation service in mental status testing is discussed.
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Acute confusion in the elderly is a problem that has high prevalence with significant morbidity and mortality, and that may lead to institutional placement. It is imperative that delirium be recognized promptly and its underlying cause(s) identified and treated. Management requires a multifaceted approach that addresses the precipitating cause(s), maintenance and support of vital functions, management of behaviors with use of nursing staff and family, attention to the environment, and sometimes the use of appropriate psychotropic medication. Prompt treatment is likely to result in a return to normalcy.