Evaluation of a shortened version of the Abbreviated Mental Test in a series of elderly patients

Abstract

The AMT4 may be useful in the initial assessment of cognition in elderly patients, with little loss of accuracy in detecting marked cognitive impairment when compared to the AMT.

Assessing cognition in elderly patients presenting to the emergency department

“…The AMT takes up to five minutes to administer and the process requires either the use of a checklist or careful memorisation of the questions. It has also been shown that very few practitioners actually use the AMT correctly and in its entirety, limiting its usability as a screening tool (Swain and Nightingale, 1997). 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).…”

“…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).…”

“…Anything less than four correct responses indicates cognitive impairment which warrants further assessment, especially if there is no history of existing cognitive impairment. Given that the AMT4 has a predictive efficiency of 91% when compared to the AMT (Swain and Nightingale, 1997), its accuracy, brevity and ease of use make it potentially more valuable than the AMT as a cognitive screening tool for nurses to use in the ED setting (Woodford and George, 2007). (Swain and Nightingale, 1997;Swain et al, 2000).…”

“…The cognitive status of patients was determined by examining their medical record for evidence of a pre-existing cognitive impairment or, where no such evidence was found, assessing their cognitive state using the AMT, a validated cognitive assessment tool (Hodkinson, 1972;Swain and Nightingale, 1997;Swain et al, 1999). The AMT requires the assessor to ask the patient a series of 10 questions to assess cognitive function and orientation, with one mark given for each correct answer (see Box 1).…”

Screening for cognitive impairment in older people attending accident and emergency using the 4-item Abbreviated Mental Test

“…The simpler 10-point Abbreviated Mental Test (AMT) [5] is recommended for routine cognitive screening of hospital patients, although it is not always used correctly [6]. Shortened versions of the AMT have been tested apparently with little loss of accuracy [7,8]. However there is sparse evidence for the use of brief cognitive assessments in A&E.…”