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This quick to use screening test was first introduced in 1972. Developed by geriatricians, this is probably the best known test in general hospital usage. The AMT score lacks validation in primary care and screening populations, most validity data refers to correlation to the mini mental state examination (MMSE). It is probably non translatable either linguistically or culturally without revalidation and it is likely that several of the questions will need alteration to bring them up to date (and then validated again). In our ever increasingly multicultural society it is not possible to recommend this test any longer especially in view of its validity data.
The Six Item Cognitive Impairment Test is a better alternative in Primary Care, which has been validated in that environment.
Reproduced from Hodkinson HM; Evaluation of a mental test score for assessment of mental impairment in the elderly. Age Ageing. 1972 Nov;1(4):233-8. By permission of Oxford University Press.
Advantages of the AMT
Simple to perform and score
Disadvantages of the AMT
Very limited validity data, Familiarity has led to numerous adaptations of the questions leading to questionable validity.
Culturally specific, validity has almost certainly deteriorated over the last 30+ years as questions such as date of First World War and name of the monarch will carry less significance in the 21st century than they did in the 20th.
At the 7/8 cut off: Sensitivity = 70-80%, Specificity = 71-90% These are overall figures (not screening population). No probability data has been found for detection of mild dementia, but correlation data suggests it would be likely to be equivalent to MMSE in a screening group (30-60% sensitivity and 90-96% specificity).
Further reading & references
- Hodkinson HM; Evaluation of a mental test score for assessment of mental impairment in the elderly. Age Ageing. 1972 Nov;1(4):233-8.
- Jitapunkul S, Pillay I, Ebrahim S; The abbreviated mental test: its use and validity. Age Ageing. 1991 Sep;20(5):332-6.
- MacKenzie DM, Copp P, Shaw RJ, et al; Brief cognitive screening of the elderly: a comparison of the Mini-Mental State Examination (MMSE), Abbreviated Mental Test (AMT) and Mental Status Questionnaire (MSQ). Psychol Med. 1996 Mar;26(2):427-30.
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Dr Huw Thomas
Dr Huw Thomas