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The move away from the provision of long‐stay beds by the NHS inevitably meant a change in function for wards for elderly patients with cognitive impairment to a more acute way of working. Literature is scarce on the role or effectiveness of the new assessment wards that have replaced them and the factors affecting outcome and the duration of stay. Evidence suggests that those patients with higher dependency levels and behavioural problems stay in hospital longer, as do those awaiting a nursing home placement.This paper reports a prospective study of a consecutive group of 101 patients who died on or were discharged from an acute assessment ward for elderly patients with cognitive impairment. Clinical characteristics were recorded according to an in‐patient dementia care pathway, which included Mini‐MOUSEPAD, Crichton activities of daily living, Mini‐Mental State Examination and the Burvill physical health score evaluations. Outcome measures were duration of stay, destination on discharge or death on the ward.Most patients had cerebrovascular disease (48%) or Alzheimer's disease (32.9%), and their average Mini‐Mental State Examination score was 14.9. The mean duration of stay was 7.9 weeks. Self‐funding status and lack of behavioural and psychological complications were associated with a reduced duration of stay. 22.2% of patients were successfully rehabilitated to their own homes, but 20% died. Discharge home was most strongly predicted by having a spouse at home, and the need for nursing home rather than residential care was related to the severity of cognitive impairment. This study concludes that patients can expect to stay in hospital for 8 weeks but two areas of concern are highlighted. Firstly, the importance of the funding of community rehabilitation for patients with memory disorders and, secondly, the importance of a spouse at home to look after the patient.

Despite evidence that early identification of dementia is of growing policy and practice significance in the UK, limited work has been done on evaluating screening measures for use in primary care. The aim of this paper is to offer a clinically informed synthesis of research and practice‐based evidence on the utility, efficacy and quality of dementia screening measures. The study has three elements: a review of research literature; a small‐scale survey of measures employed in three primary care trusts; and a systematic clinical evaluation of the most commonly used screening instruments. The authors integrated data from research and clinical sources. The General Practitioner Assessment of Cognition (GPCOG), Memory Impairment Screen (MIS) and Mini‐Cognitive Assessment Instrument (Mini‐Cog) were found to be: brief; easy to administer; clinically acceptable; effective; minimally affected by education, gender, and ethnicity; and to have psychometric properties similar to the Mini Mental State Examination (MMSE). Although the MMSE is widely used in the UK, this project identifies the GPCOG, MIS and Mini‐Cog as more appropriate for routine use in primary care. A coherent review of evidence coupled with an in‐depth evaluation of screening instruments has the potential to enhance ability and commitment to early intervention in primary care and, as part of a wider educational strategy, improve the quality and consistency of dementia screening.

Mental health assessment in people with learning disability can be a challenging process for clinicians. The more severe the cognitive impairment and level of learning disability, the less likely it is that the clinician can reliably confirm the diagnosis of a psychiatric disorder. Coordinated, multi‐modal interdisciplinary team assessment is the way forward, as it draws together the bio‐psychosocial model of interviewing and mental health care planning. In this article we go through the psychiatric assessment structure and highlight the differences in assessing people with learning disability compared with their peers in the general population. We give special consideration to mental health assessments in emergency settings, and to people with challenging behaviour.

The paper aims to investigate if the performance of older adults on the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were associated or predictive of their functional performance in a geriatric evaluation and management (GEM) inpatient hospital setting. This will inform the occupational therapy assessment and management of older adults admitted to sub-acute GEM settings.

In all, 20 participants (11 men, 9 women, mean age 82 years, SD = 6.93) were recruited from a GEM ward in an Australian hospital. Participants’ cognitive abilities were assessed using the MMSE and MoCA, and their functional performance were assessed using the Functional Independence Measure (FIM). Spearman’s rho correlations and linear regression analyses were completed. Bootstrapping was applied to the regression analyses to accommodate the small study sample size.

No statistically significant correlations were obtained between the total and subscale scores of the MMSE and FIM or between the total and subscale scores of the MoCA and FIM. In other words, the cognitive and functional abilities of older adults admitted to a GEM setting were not significantly associated in this study.

The findings suggest that the MoCA and the MMSE were not predictive of participants’ functional performance as measure by the FIM in a sub-acute GEM setting. Occupational therapists should be cautious when interpreting participants’ MMSE, MoCA and FIM results and not depend solely on these results in the goal setting and intervention planning processes for clients on GEM wards. Further studies are recommended to confirm these findings.

The assessment of patterns in risky drinking and its association with dual diagnosis in community services for older people remains under-explored. The paper aims to discuss this issue.

Drinking risk using the Alcohol Use Disorders Identification Test (AUDIT) and the presence of co-existing mental disorders was examined in 190 people aged 65 and over.

In total, 24 per cent of drinkers drank above lower risk levels and 22 per cent reported binge drinking over the past 12 months. Those scoring 1 or more on the AUDIT were more likely to be male and to have greater cognitive impairment than non-drinkers and those reporting no past problems with alcohol.

Given the limitations of the Mini Mental State Examination in the detection of alcohol related cognitive impairment (ARCI), the use of other cognitive screening instruments in larger study populations is also warranted.

Greater attention needs to be paid to the assessment of risky drinking in older male drinkers and those with cognitive impairment.

There is considerable scope for the routine detection of cognitive impairment and dementia in older people with alcohol use within mainstream mental health services, particularly in those with binge drinking. As ARCI is associated with loss of function and independence, early detection and intervention can improve health and social outcomes.

This study aims to establish a correlation between a patient’s mini mental state examination (MMSE) score and their ability to remember how to use common assistive dressing devices.

The study was a prospective, cross-sectional and correlational study. A final sample of 63 patients formed the study. Patients’ cognition was measured using the MMSE, and a new assessment tool was developed to assess patients’ ability to use three assistive devices and piloted on 15 patients to address normality, reliability, validity and clinical usefulness. Pearson’s rank correlation coefficient was used to establish direct correlations between the MMSE score and the assessment tool score. Eta squared was used to calculate the effect size to achieve an indication of the difference between the groups. Ethical approval had been granted by the regional ethics committee. The null hypothesis states that patients with an MMSE score of 22 or less show no difference in their ability to safely and appropriately use assistive devices provided and demonstrated by an occupational therapist than patients with an MMSE score of 23 or higher.

The null hypothesis was rejected and patients with an MMSE score of 22 or less showed a significant difficulty in their ability to use the three devices. Correlation coefficients showed significant positive correlations between MMSE scores and assistive devices scoring tool results for all three devices: Helping hand (r = 6.677, n = 60, p = 0.01), shoe horn (r = 0.649, n = 54, p = 0.01) and sock aid (r = 0.877, n = 54, p = 0.01).

The study is in an Irish context and demonstrated primary, objective evidence of the impact of impaired cognition on functional ability. Patients with cognitive deficits pose a larger safety challenge but still should be afforded an opportunity to use and benefit from assistive devices. The assessment tool is a new and unique instrument and although requires further development, may conceivably act not just as an assessment instrument but also an effective treatment tool.

The purpose of this paper is to examine the reliability and validity of the Abbreviated Mental Test (AMT) and the agreement with the Mini-Mental State Examination (MMSE).

This cross-sectional study included 446 older adults who were recruited by cluster sampling from 200,481 adults aged more than 60 years. For each participant, the AMT was administered by village health volunteers and, on a separate day, by a trained professional who also administered the MMSE. Descriptive statistics, Bland and Altman levels of agreement, and Receiver Operator Curves (ROCs) were used to analyze data.

Administration of the AMT by village health volunteers during the annual health screening found cognitive impairment in only 1.12% of the sample. When the AMT was given to these same individuals by trained professionals, the rate of cognitive impairment was almost 24 times greater. Two items in the Thai AMT may require modification due to markedly elevated failure rates. At the cut score of 8, the sensitivity and specificity of the AMT relative to the MMSE were moderate (78.83 and 66.67%, respectively). The degree of agreement between AMT and MMSE was 0.49 (p < 0.001) and the correlation between the difference scores and the mean is exceptionally low (0.048).

Reliable and valid cognitive screening assessment requires the administrator to be well trained and the tools to be appropriate for the population. Although AMT is short and easy for a nonprofessional to administer, some items were not suitable due to construct validity and contextual issues.

The purpose of this study is to collect the first empirical data on the cognitive state of elderly prisoners in Germany and to examine associations between cognitive function and sociodemographic, clinical and incarceration characteristics.

All prisoners aged 60 years and older of five prisons in North Rhine-Westphalia, Germany, were asked to participate. The cognitive screening instruments mini-mental state examination (MMSE) and the DemTect were used to assess global cognition. Executive functions were tested with the trail making test and the frontal-assessment-battery. The Patient Health Questionnaire (PHQ-9) was used to assess participants’ affective state.

The sample of this study consisted of 58 prisoners with a mean age of 65.52 years (standard deviation = 6.03); 82.8% are male. Using the MMSE with age- and education-corrected z-scores, 36.9% of the prisoners showed marginal or impaired global cognition scores. Using the DemTect, 41.4% of the prisoners were classified as being cognitively impaired. Up to 40% of the prisoners showed deficits in executive functioning and around 60% of the prisoners showed depressive symptoms. The correlation analysis revealed significant associations between cognitive scores and age (rho = –0.335, p = 0.014), education (rho = 0.309, p = 0.020), sentence duration (rho = 0.409, p = 0.007) and duration of current incarceration (rho = 0.302, p = 0.043). The DemTect total score was significantly associated with the PHQ-9 (rho = –0.335, p = 0.016).

A large group of the prisoners showed a higher prevalence of cognitive dysfunction than that observed in same-age people who are not incarcerated. Taken together, there is an urgent need for an adequate management of older cognitively impaired prisoners including routine cognitive testing and guidelines-oriented treatment of cognitive symptoms.

This study has several strengths. To the best of the authors’ knowledge, this is the first study examining the cognitive and affective state in a German prison population. The authors considered female and male prisoners, as well as different prison settings, representing a realistic prison sample. The authors used several neuropsychological instruments to get a more detailed insight into the older prisoners’ cognitive status while trying to consider the economy of time and possible attention deficits to prevent dropouts during testing.

Aging adults from low-income residential areas were found to have poor nutritional status and mental health based on National Health and Morbidity Survey Malaysia (2015). Good nutrient intake contributes positively in averting these problems. Traditional Asian vegetables (ulam) are rich in polyphenols, antioxidants and fibres which could enhance nutritional status and mood state. This study intended to determine the relationship between habitual ulam intake and nutritional status, mood state and cognition among 252 aging Malaysian adults aged 45–80 years from the low-income residential areas in Klang Valley, Malaysia.

It was a cross-sectional study that used convenient sampling. Advertisement and invitation letters were sent to three selected community centres in Klang Valley prior to data collection. Informed consent was obtained prior to the collection of socio-demographic data. Anthropometric measurement was performed as per standard protocols. Validated surveys were conducted to obtain information on ulam consumption, mood state and cognitive status using validated food frequency questionnaires, Profile of Mood State and Mini-Mental State Examination questionnaires, respectively.

The average of ulam intake was 20.5 ± 2.5 g/day (½ serving daily). Habitual ulam intake was associated with lower waist circumference (R² = 0.166, β = −0.216, p < 0.01), better MMSE scores (R² = 0.337, β = 0.128, p < 0.05), less anger (R² = 0.081, β = −0.116, p < 0.05), less tension (R² = 0.139, β = −0.204, p < 0.01) and positive total mood disturbance (R² = 0.095, β = 0.164, p < 0.05) after adjustment for gender, age, energy intake, total fruits and vegetables (non-ulam) consumption. The ulam intake at 100th percentile (=30g/day) associated to a better nutritional status, mood state and cognitive status in comparison to 25th percentile (<7.9 g/day) (p < 0.05).

Findings from this research would recommend people to consume not less than 1 serving of ulam everyday in order to have improved nutritional status, mood and cognition; nonetheless, future studies are required to clarify the causal mechanism concerning this relationship.

Effective cognitive functioning elucidates the orchestrated interplay of diverse mental faculties in addressing daily tasks, potentially indicative of an improved state of an individual’s health. Linked to this is the potential role of life satisfaction, which may aid individuals in better managing their health-related challenges. The purpose this study is to examine whether the cognitive functioning and life satisfaction levels of elderly individuals serve as predictors of their subjective health complaints.

The research involved a cohort of 126 elderly community residents. The assessment tools used encompassed a socio-demographic questionnaire, the mini-mental state examination (MMSE), the scale of subjective health complaints and a life satisfaction scale.

The findings reveal that both cognitive functioning and life satisfaction are predictive variables for subjective health complaints, validated in both the original sample and simulated samples.

This study’s innovation lies in highlighting the importance of cognitive functioning and life satisfaction among the elderly population as explanatory factors for subjective health complaints. Consequently, these dimensions warrant consideration in specialized intervention programs aimed at promoting the health and quality of life among the elderly.