Rehabilitation therapists' recognition of cognitive and mood disorders in geriatric patients

Objective: To determine if physical and occupational therapists can recognize 2 known predictors of rehabilitation outcome, cognition and mood, in their geriatric patients. Design: Survey. Setting: Urban academic medical center rehabilitation unit. Participants: One hundred two consecutive geriatric admissions rated by 20 physical and 8 occupational therapists for the presence of cognitive or affective disorders. Interventions: Not applicable. Main Outcome Measures: Mini-Mental State Examination, Geriatric Depression Scale, and therapists' ratings. Results: Both disciplines had low rates of accurate detection of both cognitive abnormalities and symptoms of depression. Patients scoring in the intact range of either domain were more likely to be correctly identified by the therapists than were patients whose results were possibly or probably impaired. Conclusion: Rehabilitation therapists had difficulty recognizing patients with cognitive and affective disorders. I recommend including a mental health professional on the treatment team, staff inservicing, and/or the use of standardized measures of mood and mental status to increase recognition of these syndromes in geriatric rehabilitation patients.