![]() ![]() Patients were included if they were over 18 years of age, clinically stable at baseline (defined as no change in medication dosage or frequency and no recent change or exacerbation in their medical condition on day 1, not receiving end-of-life care confirmed by the clinical nurse manager), if their remaining admission was expected to be greater than three days, and if they were able to provide informed written consent. ![]() Patients were assessed for a minimum of three days and up to a maximum of five consecutive days. Suitable patients were selected using convenience sampling directed by a neutral party (clinical nurse manager) to minimise selection bias. Patients admitted to wards in two university teaching hospitals (one acute geriatric hospital and one adult rehabilitation unit) in Cork City, Ireland, in May 2013 were invited to participate. Further study is required to define the properties of an ideal CVS test, though LM may satisfy these. LM is a reliable measure of cognition showing diurnal variation but minimal learning effects. All nurses reported that LM was feasible to score routinely. LM scores were statistically similar ( p = 0.98) with repeated testing (suggesting no learning effect). A diurnal fluctuation of two points from a total of 30 was deemed acceptable in clinically stable patients. Inter-rater reliability was excellent with correlation coefficients for LM increasing from r = 0.87 on day 1 to r = 0.97 by day 4 ( p < 0.0001). Scores were compared to those of an expert rater. Trained nursing staff performed twice-daily cognitive assessments on 84 clinically stable inpatients in two geriatric units over 3–5 consecutive days using LM and short tests of attention and orientation including months of the year backwards. We evaluated the reliability, responsiveness, and feasibility of logical memory (LM), immediate verbal recall of a short story, compared to brief tests of attention as a bedside “cognitive vital sign” (CVS). Although there is a high prevalence of delirium and cognitive impairment among hospitalised older adults, short, reliable cognitive measures are rarely used to monitor cognition and potentially alert healthcare professionals to early changes that might signal delirium. ![]()
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