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Is There an Association between Norton Scale and Cognitive Impairment in Hip Fractured Elderly Patients?
Kagansky, Nadya; Stambler, Ilia; Mizrahi, Eliyahu Hayim.
  • Kagansky N; Medical Geriatric Center Shmuel Harofe, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
  • Stambler I; Medical Geriatric Center Shmuel Harofe, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
  • Mizrahi EH; Medical Geriatric Center Shmuel Harofe, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Dement Geriatr Cogn Disord ; 50(6): 535-540, 2021.
Article in English | MEDLINE | ID: covidwho-1574687
ABSTRACT

INTRODUCTION:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSION:

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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cognitive Dysfunction / Hip Fractures Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research Limits: Aged / Humans Language: English Journal: Dement Geriatr Cogn Disord Journal subject: Geriatrics / Neurology / Psychiatry Year: 2021 Document Type: Article Affiliation country: 000520852

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cognitive Dysfunction / Hip Fractures Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research Limits: Aged / Humans Language: English Journal: Dement Geriatr Cogn Disord Journal subject: Geriatrics / Neurology / Psychiatry Year: 2021 Document Type: Article Affiliation country: 000520852