A comparative study of Mini-Mental Test, Clock Drawing Task and Cognitive-FIM in evaluating functional outcome of elderly hip fracture patients

Objective: To compare the clock drawing task with other cognitive tests used for the prediction of discharge functional outcome, in elderly hip fracture patients. Design: Cohort study. Setting: A department of geriatric-orthopaedic rehabilitation of a tertiary hospital. Patients: One hundred and forty-three consecutive patients undergoing inpatient comprehensive rehabilitation following hip fracture. Measurements: Cognitive status was assessed by the Clock Drawing Task, Mini-Mental State Examination (MMSE) and the Cognitive-FIM (cognFIM). Functional status outcome was evaluated by the Functional Independence Measure (FIM), using absolute and relative parameters of efficacy and efficiency. Results: Correlation coefficients (Pearson correlation) between the three cognitive tests resulted in values ranging from 0.607 to 0.732 (p < 0.001). Similar correlation coefficients were observed for all cognitive tests when correlated with relative efficacy and efficiency outcome parameters (p < 0 001), but not with absolute outcome parameters. Conclusions: Clock Drawing Test is similar to Mini-Mental and Cognitive-FIM with respect to the evaluation of functional status outcome following rehabilitation of hip fractures. The similar correlations with functional outcome parameters as well as the simplicity of administration favour the use of either Clock Drawing Task or MMSE in the initial assessment of elderly patients with hip fractures.