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Screening for cognitive impairment in older general hospital patients: comparison of the Six‐Item Cognitive Impairment Test with the Mini‐Mental State Examination
Author(s) -
Tuijl Jolien P.,
Scholte Evert M.,
Craen Anton J.M.,
Mast Roos C.
Publication year - 2012
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2776
Subject(s) - medicine , cognitive impairment , mini–mental state examination , cutoff , cognition , test (biology) , cognitive disorder , dementia , physical therapy , psychology , psychiatry , paleontology , physics , quantum mechanics , biology , disease
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. Method 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. Copyright © 2011 John Wiley & Sons, Ltd.