Skip to main content

Main menu

  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us

Clinical Medicine Journal

  • ClinMed Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About ClinMed
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

User menu

  • Log in

Search

  • Advanced search
RCP Journals
Home
  • Log in
  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us
Advanced

Clinical Medicine Journal

clinmedicine Logo
  • ClinMed Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About ClinMed
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

Is it time to replace the Abbreviated Mental Test Score as a screening tool for dementia?

Michelle Willmott
Download PDF
DOI: https://doi.org/10.7861/clinmedicine.15-3-s9
Clin Med June 2015
Michelle Willmott
North West London Hospitals NHS Trust, London, UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
Loading

Aims

To compare the case-finding ability of the Abbreviated Mental Test Score (AMTS) to the mini-COG in elderly hospitalised patients, with the ultimate aim of improving screening for dementia.

Methods

The AMTS and mini-COG were administered to a cohort of 40 inpatients aged 68–94 (median age 82, mean age 81.1) over a 2-week period. Three doctors administered the tests and one doctor performed all of the scoring.

Results

Of the 40 patients screened, eight were identified as ‘cases’ by the AMTS. The mini-COG identified the same eight patients, but went on to detect a further 11 ‘cases’.

All 11 of these additional ‘cases’ had abnormal clock-draws. The following are examples of clock-draws from two of these 11 patients who had a normal AMTS but an abnormal mini-COG. It is immediately obvious that there is significant visual–spatial impairment in both of these patients, and that further diagnostic assessment should be performed.

Conclusions

Dementia is a prevalent, costly but under-diagnosed condition that has been made a focus of this government's healthcare policy and current research drives, culminating most recently with the discovery of diagnostic serum markers in July 2014. The prime minister's ‘Dementia Challenge’, launched in 2012, aimed to raise the diagnostic rate above its current 45% and financially incentivised hospital trusts to do this through the Dementia Commissioning for Quality and Innovation (CQUIN) scheme, which allows trusts to earn up to £54m a year for reaching specific targets. Sixty per cent of the budget alone is allocated to trusts that attain a 90% case-finding target.

In order to achieve this, hospitals need a rapid and valid screening tool for dementia to use in the emergency department. The AMTS (designed in 1972) may not be fit for purpose in today's multi-ethnic patient cohort. No previous studies have compared the AMTS to the mini-COG – a newer and quicker screening tool, with minimal language content that reduces its educational and cultural bias. This preliminary audit shows that the mini-COG identified more potential ‘cases’ in this patient cohort than the AMTS; these will now need to be followed up prospectively to see whether they are diagnosed with dementia.

In summary, these results suggest that the mini-COG is a better screening tool for dementia than the AMTS in this patient cohort, and could therefore supersede its use. Further follow-up is needed to provide more evidence to support this.

Conflict of interest statement

None declared.

Fig 1.
  • Download figure
  • Open in new tab
  • Download powerpoint
Fig 1.

Clock draws.

  • © Royal College of Physicians 2015. All rights reserved.
Back to top
Previous article

Article Tools

Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
Is it time to replace the Abbreviated Mental Test Score as a screening tool for dementia?
Michelle Willmott
Clinical Medicine Jun 2015, 15 (Suppl 3) s9; DOI: 10.7861/clinmedicine.15-3-s9

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Is it time to replace the Abbreviated Mental Test Score as a screening tool for dementia?
Michelle Willmott
Clinical Medicine Jun 2015, 15 (Suppl 3) s9; DOI: 10.7861/clinmedicine.15-3-s9
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Aims
    • Methods
    • Results
    • Conclusions
    • Conflict of interest statement
  • Figures & Data
  • Info & Metrics

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Helping patients and the emergency department: enhanced patient care and reduced hospital admission rates with a pilot rapid access neurology clinic (RANC)
  • Improving identification of malnutrition in older patients admitted acutely to hospital
  • Direct access echocardiography to a district general hospital: are patients being screened appropriately?
Show more SCREENING

Similar Articles

Navigate this Journal

  • Journal Home
  • Current Issue
  • Ahead of Print
  • Archive

Related Links

  • ClinMed - Home
  • FHJ - Home
clinmedicine Footer Logo
  • Home
  • Journals
  • Contact us
  • Advertise
HighWire Press, Inc.

Follow Us:

  • Follow HighWire Origins on Twitter
  • Visit HighWire Origins on Facebook

Copyright © 2021 by the Royal College of Physicians