The 6-Item Cognitive Impairment Test as a bedside screening for dementia in general hospital patients: results of the General Hospital Study (GHoSt).
The objective of this study was to examine the psychometric quality of the 6-Item Cognitive Impairment Test (6CIT) as a bedside screening for the detection of dementia in general hospital patients.



Participants (N = 1,440) were inpatients aged ≥65 of 33 randomly selected general hospitals in Southern Germany. The 6CIT was conducted at bedside, and dementia was diagnosed according to DSM-IV. Nursing staff was asked to rate the patients' cognitive status, and previous diagnoses of dementia were extracted from medical records. Completion rates and validity statistics were calculated.



Two-hundred seventy patients had dementia. Cases with delirium but no dementia were excluded. Feasibility was 97.9% and 83.3% for patients without and with dementia, respectively, and decreased from moderate (93.8%) to severe dementia (53%). The area under the curve of the 6CIT was 0.98. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated for the cutoffs 7/8 (0.96, 0.82, 0.85, 0.52, 0.99) and 10/11 (0.88, 0.95, 0.94, 0.76, 0.98). The nurse ratings and medical records information had lower validity statistics. Logistic regression analyses revealed that the 6CIT statistically significantly provided information above nurse ratings and medical records. Twenty-five and 37 additional patients were correctly classified by the 7/8 and 10/11 cutoffs, respectively.



The 6CIT is a feasible and valid screening tool for the detection of dementia in older general hospital patients. The 6CIT outperformed the nurse ratings of cognitive status and dementia diagnoses from medical records, suggesting that standardized screening may have benefits with regard to case finding. Copyright © 2016 John Wiley & Sons, Ltd.
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, München, Germany.
Johannes Baltasar
0000-0002-6994-7951
JB
Hessler
Faculty of Social Work, Mannheim University of Applied Sciences, Mannheim, Germany.
Martina
M
Schäufele
Faculty of Social Work, Mannheim University of Applied Sciences, Mannheim, Germany.
Ingrid
I
Hendlmeier
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, München, Germany.
Magdalena
M
Nora Junge
Faculty of Social Work, Mannheim University of Applied Sciences, Mannheim, Germany.
Sarah
S
Leonhardt
Faculty of Social Work, Mannheim University of Applied Sciences, Mannheim, Germany.
Joshua
J
Weber
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, München, Germany.
Horst
H
Bickel
D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis*; D003693:Delirium / Q000523:psychology; D003704:Dementia / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D005858:Germany; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D019095:Point-of-Care Systems; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics / Q000592:standards; D012680:Sensitivity and Specificity
6CIT; cognitive screening; dementia; general hospital