title: Screening for cognitive impairment in older general hospital patients: comparison of the Six-Item Cognitive Impairment Test with the Mini-Mental State Examination.
abstract: OBJECTIVE
  To investigate the performance and usability of the Six-Item Cognitive Impairment Test (6CIT) as a screening instrument for cognitive impairment in older, general hospital inpatients/outpatients.
  
  
  METHODS
  In 253 general hospital patients aged ≥ 70 years, diagnostic accuracy of the 6CIT and time required to administer it were assessed using the Mini-Mental State Examination (MMSE) as the criterion standard.
  
  
  RESULTS
  The (negative) correlation between the 6CIT and the MMSE was very high (r = -0.82). Optimal comparability was found using a MMSE cutoff of ≤19 for lower and ≤23 for higher educated patients, at a cutoff of ≥11 on the 6CIT that was not sensitive to educational level. The sensitivity of the 6CIT was 0.90 and the specificity was 0.96, whereas the positive predictive value was 0.83 and the negative predictive value was 0.98. The area under the curve was 0.95. The mean administration time was 5.8 min for the MMSE and 2.5 min for the 6CIT (p ≤ 0.01).
  
  
  CONCLUSIONS
  Diagnostic accuracy of the 6CIT was high. As the 6CIT is not sensitive to educational level, does not require advanced language skills, only takes a few minutes to administer and is very easy to use, it appears to be a suitable screening instrument for cognitive impairment in older patients in the general hospital.
authors.affiliation: Department of Geriatrics, Bronovo Hospital, The Hague, The Netherlands. jptuijl@bronovo.nl
authors.forename: Jolien P
authors.initials: JP
authors.lastname: Tuijl
authors.forename: Evert M
authors.initials: EM
authors.lastname: Scholte
authors.forename: Anton J M
authors.initials: AJ
authors.lastname: de Craen
authors.forename: Roos C
authors.initials: RC
authors.lastname: van der Mast
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000295:instrumentation*; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales / Q000592:standards; D012372:ROC Curve; D012680:Sensitivity and Specificity