title: Screening for cognitive impairment in older people attending accident and emergency using the 4-item Abbreviated Mental Test.
abstract: To determine the utility of the 4-item Abbreviated Mental Test (AMT4) for detecting cognitive impairment in accident and emergency patients aged 65 years or older. Cognitive function was assessed using the Mini Mental State Examination (MMSE), 4 and 10-point AMT and subjective judgment. Cognitive impairment was defined as an MMSE score 23/30 or less. Of 601 patients, 226 (37.6%) scored 23 or less on MMSE. Cutoffs of 3 or less for AMT4 and 7 or less for AMT had sensitivities of 80% [95% confidence interval (CI): 0.75-0.85] and 76% (95% CI: 0.69-0.81), and specificities of 88% (95% CI: 0.84-0.91) and 93% (95% CI: 0.90-0.96), respectively, for detection of cognitive impairment; subjective judgement of admitting nurse had 50.5% (95% CI: 44-57%) sensitivity and 98.6% (95% CI: 0 96-1.00%) specificity. In conclusion, the AMT4 performs as well as the 10-point AMT in screening for cognitive impairment, and will assist in the early detection of cognitive problems.
authors.affiliation: Glasgow Caledonian University, Glasgow, UK. I.Schofield@gcal.ac.uk
authors.forename: Irene
authors.initials: I
authors.lastname: Schofield
authors.forename: David J
authors.initials: DJ
authors.lastname: Stott
authors.forename: Debbie
authors.initials: D
authors.lastname: Tolson
authors.forename: Angus
authors.initials: A
authors.lastname: McFadyen
authors.forename: James
authors.initials: J
authors.lastname: Monaghan
authors.forename: Derek
authors.initials: D
authors.lastname: Nelson
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D016001:Confidence Intervals; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D008403:Mass Screening; D011581:Psychological Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D006113:United Kingdom