Impaired cognition in the critically ill elderly patient: clinical implications.

Cognitive impairment is a significant health problem for the critically ill aged and warrants further investigation. Despite the lack of knowledge of all aspects of cognitive impairment, much can be undertaken to improve the care of impaired patients. Nurses must routinely, systematically, and comprehensively assess the cognitive state of each elderly patient at the time of admission and daily throughout hospitalization. On the basis of these assessments, nurses must accurately differentiate among confusion, depression, and dementia in the cognitively impaired patient. To carry out such assessments, modification of existing tools, such as the MMSE, may be necessary. Only through such assessment, however, is it possible to detect, prevent, or treat changes in cognition, and thereby prevent its sequelae.