Cognitive assessment in elderly patients admitted to hospital: the relationship between the shortened version of the Abbreviated Mental Test and the Abbreviated Mental Test and Mini-Mental State Examination

Abstract

The selection of patients, exclusions, assessments and analyses have been described previously. 8 Briefly, all patients aged 60 years and above admitted to the Department of Elderly Medicine during October and November 1997 were included in the study. Patients were assessed with the AMT followed by the MMSE, once the acute phase of the admission was over. The AMT4 score was derived from the AMT score. An AMT4 score of 0-3 indicated impaired cognition and a score of 4 normal cognition. 6 The AMT4 score was compared with the AMT and MMSE scores for each patient. Results During the study period 364 patients were admitted to the Department of Elderly Medicine, of whom 88 (24.2%) were excluded, leaving a study group of 276 patients. There was a strong relationship between the AMT4 and AMT when analysed dichotomously: χ 2 = 121.2, df = 1, p < 0.001. The predictive efficiency of the AMT4 for cognitive state by the AMT was 83.3% (230/276). The remaining performance parameters of the AMT4 against the AMT were as follows: positive predictive value 78.1% (107/137), negative predictive value 88.5% (123/139), sensitivity 87.0% (107/123) and speci

Cataract extraction and patient vision-related quality of life: a cohort study

“…Cognitive assessment was measured using the 4-item Abbreviated Mental Test, 16 which asked the following questions: (1) Age, (2) Date of birth, (3) Place, and (4) Year. Those scoring o4 indicated cognitive impairment and were excluded from analysis.…”

Assessing cognition in elderly patients presenting to the emergency department

“…The AMT used to assess the cognitive status of the target patients in this audit was selected because it has been described as a validated, easy to administer test which is useful in screening cognitive functioning (Swain et al, 2000). However, some difficulties were found relating to its use as a cognitive screening tool in the ED.…”

“…The AMT has been shown to have a predictive efficiency of 79%, with high positive predictive value (92.7%), high specificity (92.0%) and reasonable sensitivity (69.9%) when compared to the MMSE (Swain et al, 1999). A much shorter four item test known as AMT4 (Swain and Nightingale, 1997;Swain et al, 2000) may be a more suitable tool to use for screening by nurses in the Emergency Department, as it is brief, does not ask questions which require visual acuity or access to a clock and does not require culturally specific responses, although in some cases the date of birth may not be known. When compared to the MMSE, the AMT4 has a predictive efficiency of 73.2%, a positive predictive value of 82.5% and specificity of 78.8% (Swain et al, 2000).…”

“…A much shorter four item test known as AMT4 (Swain and Nightingale, 1997;Swain et al, 2000) may be a more suitable tool to use for screening by nurses in the Emergency Department, as it is brief, does not ask questions which require visual acuity or access to a clock and does not require culturally specific responses, although in some cases the date of birth may not be known. When compared to the MMSE, the AMT4 has a predictive efficiency of 73.2%, a positive predictive value of 82.5% and specificity of 78.8% (Swain et al, 2000). The AMT4 is used to test cognitive function by asking the patient to answer four questions (see Box 4).…”

Acute geriatrics at the front door

“…The 4-point Abbreviated Mental Test score (AMT-4) is quick to complete and has good correlation with the 10-point scale but is easier to applyrequiring only place, age, date of birth and year. 9 The detection of cognitive impairment should always be accompanied by an assessment for delirium, for example using the 4-AT. 10 Delirium has acute onset, typically over days and weeks.…”