[Influence of cognition on treatment outcome in geriatric patients: association between MMSE and gain in activities of daily living]

Abstract

Background: Cognitive impairment or dementia influence the results of geriatric treatment. The aim of the study was to quantify this influence.

Patients and methods: Data of 2527 patients from the years 2006 to 2009 were analysed in order to quantify the influence of cognition measured with the Mini Mental Status Examination (MMSE) on the improvement of activities of daily living as reflected by the Functional Independence Measure (FIM).

Results: Impaired cognition is accompanied by a lower FIM score on admission and on discharge. But the improvement of the FIM of slightly cognitively impaired patients (MMSE 20-26) is the same as in patients without cognitive impairment (MMSE 27-30). Patients with a MMSE below 20 points have smaller improvements in their FIM score but nevertheless 40 % of the patients with a MMSE of 10-19 and still 30 % of the patients with a MMSE of 0-9 points show better improvements than the average of all patients.

Conclusion: Patients with a MMSE below 20 should not generally be excluded from geriatric treatment, but individual factors should be considered.