AMTS

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AMTS

• Abbreviated Mental Test Score
• Hodkinson Test

2
AMTS

• Screening test for cognitive impairment
• Tests orientation, recall, language and current
  knowledge
• Is highly suited to use within hospitals
• Is quick and easy to use.

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AMTS

• However
• It cannot help with differential diagnosis.
• Depressed and aphasic patients may not do well on
  this test even if they do not have a memory
  problem
• it is unsuitable to monitor disease progression

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AMTS

• Maximum score 10
• Score below 7 suggests cognitive impairment
• Further evaluation is then required

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Performing the test

• LGI paper Holmes / Gilbody 1996
• 105 doctors contacted
• 1 unware of AMTS
• 82 used incomplete / wrong set of questions
• 103 scored incorrectly
• 78 incorrectly used half marks
• 41 misdiagnosed respondent as cognitively intact
• 1 doctor scored correctly

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Performing the test

• Age
• Score for exact age only
• Date of birth
• Score for correct date and month (year not
  required)
• Year
• Score for current year only
• Time of day
• Score if correct to the nearest hour

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Performing the test

• Place
• Score if exact address or name of hospital given
  ("in hospital" is insufficient)
• Monarch
• Score for current monarch only
• Year of first world war
• Score for year of start or finish (both not
  necessary)

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Performing the test

• Counting backwards from 20 to 1
• Score if no mistakes or subject corrects himself
  or herself spontaneously
• Recognition of two people
• Score if roles of two people correctly
  recognised--for example, doctor and nurse
• Recall of three point address such as 42 West
  Street
• Score if registered correctly near beginning of
  test and on recall at end of test

9
MMSE

• Mini Mental State Examination
• (Folstein et al.)
• Valid diagnosis of cognitive impairment
• Differential diagnosis possible
• More time consuming ( gt10 min)
• not recommended as a screening instrument for the
  detection of early stages of dementia
• Influenced by age and education

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6CIT

• 6 Item Cognitive Impairment Test
• brief and reliable instrument for identifying
  cognitive impairment
• diagnostic properties comparable to full MMSE
• telephone interview possible

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Question Score range Weighting Weighted score
What Year is it 0-1 x4
What month is it 0-1 x3
Give the memory phrase e.g. (John Smith 42 West Street Bedford)
About what time is it 0-1 x3
Count back from 20-1 0-2 x2
Say months in reverse 0-2 x2
Repeat the memory phrase 0-5 x2
Total score for 6CIT 0-28
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References

• Holmes J, Gilbody S
• Differences in use of abbreviated mental test
  score by geriatricians and psychiatrists
• BMJ 1996313465 (24 August)
• Tangalos EG, Smith GE, Ivnik RJ, Petersen RC,
  Kokmen E, Kurland LT, Offord KP, Parisi JE.
• The Mini-Mental State Examination in general
  medical practice clinical utility and
  acceptance.Mayo Clin Proc. 1996
  Sep71(9)829-37.
• Lomholt RK, Jurgensen
• The mini-mental state examination in screening
  of cognitive dysfunction and dementiaUgeskr
  Laeger. 1998 Dec 7160(50)7251-4.
• Callahan CM, Unverzagt FW, Hui SL, Perkins AJ,
  Hendrie HC
• Six-item screener to identify cognitive
  impairment among potential subjects for clinical
  research.Med Care. 2002 Sep40(9)771-81.
• Health And Age WebSite
• Novartis Foundation for Gerontology 2002

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Thank you!