Značaj procene kognitivnog statusa pacijenata u ambulanti opšte medicine

Abstract

Introduction: The rising trend of population aging and dementia, on the one hand, and the lack of recommendation on the application of non-selective dementia screening in the general population of elderly patients, on the other hand, led us to our research. Objective: Examine the possibilities and significance of assessing and mon­itoring the cognitive status of patients older than 50 years of age in the practice of general practitioners. Method: A Mini Mental State Examination (MMSE) was used to assess the cognitive status of patients. Initial testing was performed in 120 patients older than 50 years of age. Patients with borderline and lower scores on MMSE were included in further testing (laboratory, ultrasound, radiological) and were referred to a psychiatrist and/or neurologist, with the follow-up of MMSE over the next two years. The values of the MMSE initial inspection, and testing scores were compared after one year. Results: Borderline and lower values at the MMSE were present in 34.2% of all respondents. At the end of the study, depression, dementia and mild cognitive impairment (MCI) were diagnosed in 24.4% of patients. In 14.6% of patients, a second subclinical disorder was found, whose treatment led to the normalization of MMSE. The Mann-Whitney U-test showed a statistically significant difference (Z = -1.986; p = 0.048) in the MMSE scores a year after initiating therapy between two groups of patients suffering from somatic illness or depression and those with MCI or dementia. Conclusion: Our research proves the multiple importance of assessing the cognitive status of elderly patients. It is possible to apply MMSE in the practice of general practitioners for initial assessment and monitoring of the cognitive status of patients with various medical disorders, as well as monitoring of the effects of somatic illness and depression treatment.