Mini-Cog assessments feasible for pharmacy students to evaluate cognitive function in elderly patients

Elderly patients with cognitive impairment may have trouble understanding and complying with medical instructions provided during hospitalization, suggests a study. Pharmacy students, however, can perform Mini-Cog assessments to examine cognitive function, which allow them to tailor education content and involve caregivers when needed.

To evaluate the prevalence of cognitive impairment among older patients (aged ≥65 years) within 24 hours of hospital admission, Mini-Cog assessments were carried out by advanced pharmacy practice experience (APPE) students. These students on APPE rotations were trained to perform Mini-Cog assessments during routine medication education session from February 2017 to April 2017.

The prevalence of cognitive impairment as indicated by a Mini-Cog score of ≤3 was the primary endpoint. Secondary endpoints were the average number of observed Mini-Cog practice assessments required for APPE students to meet competency requirements, caregiver identification and 30-day hospital readmissions.

Twelve APPE students completed the training programme after an average of 4.4 graded Mini-Cog assessments. A total of 1,159 admissions were screened, of which 273 were included in the analysis.

More than half of these admissions (n=149; 55 percent, 95 percent confidence interval [CI], 48–61 percent) were positive for cognitive impairment. A caregiver was identified for 113 patients (41 percent, 95 percent CI, 35–47 percent), and 79 had a caregiver present at bedside during the visit.

In addition, 41 patients (15 percent, 95 percent CI, 11–20 percent) were readmitted to the hospital within 30 days of discharge.

“Older adults with cognitive impairment may have difficulty understanding and complying with medical or medication instructions provided during hospitalization which may adversely impact patient outcomes,” the authors said.