Medical Geriatric Center Shmuel Harofe, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Dement Geriatr Cogn Disord. 2021;50(6):535-540. doi: 10.1159/000520852. Epub 2021 Dec 16.
Geriatric assessment as an integrative part of assessment is a composite of a large number of scales. Sometimes it is difficult to transfer all of them. The Norton Scale Score (NSS) assesses the degree of risk to develop bedsores. In previous studies, a correlation between Norton Scale and function was found. A correlation between Norton Scale and cognitive assessments was not evaluated yet. The aim of this study was to determine if there is an association between Norton Scale Score and cognitive impairment. This association can further facilitate geriatric assessment in frail older patients, especially in older patients with communicative difficulties.
We have performed an observational cohort study which included hip fractured older patients consecutively admitted to the rehabilitation ward of the Shmuel Harofe Geriatric Medical Center. The collected data included demographic data and data on chronic illnesses. Results of cognitive status assessment (Mini-Mental State Examination - MMSE) and Norton Scale assessment were received from the computerized patients' charts. We evaluated the association between these 2 scales.
The study included 224 consecutive hip fracture patients with a mean age of 81.78 ± 7.19 years. Norton scores at admission, age, education, and previous stroke emerged as the only statistically significant parameters differing between those with cognitive decline and those without it. After adjusting for confounding variables, lower Norton scores at admission (OR 1.303, CI: 1.097-1.548, p = 0.003) were associated with an increased risk finding for cognitive impairment.
Our findings suggest that there is an association between Norton Scale Scores and cognitive impairment. Norton score parameters, under certain circumstances, such as speech and other communication difficulties, can be used as a proxy measure for MMSE to indicate cognitive impairment. These findings can be even more helpful in the present time of "COVID-19," when we have to evaluate older patients with facial masks and other defensive suits.
老年综合评估是评估的一个综合部分，由大量量表组成。有时很难将所有量表都转化为简体中文。诺顿量表评分（NSS）评估发生压疮的风险程度。在以前的研究中，发现了诺顿量表与功能之间的相关性。然而，尚未评估诺顿量表与认知评估之间的相关性。本研究旨在确定诺顿量表评分与认知障碍之间是否存在关联。这种关联可以进一步促进虚弱老年患者的老年综合评估，尤其是在沟通困难的老年患者中。
我们进行了一项观察性队列研究，该研究纳入了连续入住 Shmuel Harofe 老年医学中心康复病房的髋部骨折老年患者。收集的数据包括人口统计学数据和慢性疾病数据。认知状态评估（简易精神状态检查-MMSE）和诺顿量表评估的结果从计算机化的患者图表中获得。我们评估了这两个量表之间的关联。
该研究共纳入 224 例连续髋部骨折患者，平均年龄为 81.78 ± 7.19 岁。入院时的诺顿评分、年龄、教育程度和既往卒中是认知能力下降和未下降患者之间唯一有统计学差异的参数。在调整了混杂变量后，入院时较低的诺顿评分（OR 1.303，CI：1.097-1.548，p = 0.003）与认知障碍的风险增加相关。
我们的研究结果表明，诺顿量表评分与认知障碍之间存在关联。在某些情况下，如言语和其他沟通困难，诺顿评分参数可以作为 MMSE 的替代指标来指示认知障碍。在当前“COVID-19”时期，我们必须评估佩戴口罩和其他防护装备的老年患者，这些发现可能会更有帮助。
