Abbreviated Mental Test
The Abbreviated Mental Test (AMT) is a cognitive screening method that helps in the assessment of cognitive impairment in elderly patients. It consists of 10 questionnaires that allow the healthcare providers to quickly evaluate a patient’s mental function and memory. Many hospitals, nursing homes, and GP practices utilize it.
What is the Abbreviated Mental Test Calculator?
The Abbreviated Mental Test Calculator is a digital tool that simplifies the scoring process of the AMT. It provides a quick and accurate evaluation of neurological function. You can easily add it to your electronic health records to make documentation more efficient.
How to use the AMT Calculator:
Simply input the patient’s responses to the 10 questions into the calculator, and it will automatically generate a total score. After getting this score, it’s easy and quick to figure out how much cognitive deficit the patient has.
The abbreviated mental test score (AMTS)
Hodgkinson was the one who initially developed and validated the AMTS in 1972.
The AMTS was initially developed to detect the presence of dementia; however, it is now commonly used to identify any confusion (acute or chronic) in patients. The AMTS is a valuable tool for healthcare professionals to quickly assess cognitive function and determine appropriate next steps for patient care (both acute and chronic).
| AMT Questions | Scoring |
|---|---|
| What is your age? | 1 point |
| What is the time to the nearest hour? | 1 point |
| Give the patient an address, and ask him or her to repeat it when the test is over, e.g, 42 West Street. | 1 point |
| What is the year? | 1 point |
| What is your address? name of the hospital or number of the residence where the patient is situated. | 1 point |
| What jobs do these people do?(Postman, Cook) Check if the patient recognizes two persons (postman, cook, the doctor, nurse, home help, etc). | 1 point |
| What is your date of birth? | 1 point |
| In which year did the First World War begin? (adjust this for a world event the patient would have known during childhood) | 1 point |
| Who is the present monarch/president/prime minister? | 1 point |
| Count backwards from 20 down to 1. | 1 point |
Interpretation of Results:
- 0-3 points: Severe cognitive impairment
- 4-6 points: Moderate cognitive impairment
- 7-9 points: Mild cognitive impairment
- 10 points: No cognitive impairment
What is AMT-4?
It is a short form of AMT-10. It consists of four questions that evaluate orientation and memory skills, with a scoring system that indicates the level of impairment present in the individual.
A total of four AMTS components make up the AMT-4:
- What is your age?
- What is your date of birth?
- What is the name of this place?
- What is the year?
It is part of the 4AT score for Delirium Screening which is a valuable initial screening method with high sensitivity for identifying delirium. You can check your mental health and level of depression with Geriatric Depression Scale
Application of AMT-10 and AMT-4
The abbreviated mental calculation test is used to assess mental confusion in many diseases and conditions, including:
- Dementia: Alzheimer’s disease, vascular dementia, frontotemporal dementia, and Lewy body dementia.
- Delirium: Acute confusion, altered mental status, and disorganized thinking.
- Stroke: Cognitive impairment after stroke
- Traumatic Brain Injury (TBI): Cognitive impairment after head trauma.
- Neurodegenerative diseases: Parkinson’s disease, Huntington’s disease, and amyotrophic lateral sclerosis (ALS).
- Substance abuse: Alcohol and drug-related cognitive impairment.
- Aging-related cognitive decline: Age-related cognitive impairment, mild cognitive impairment (MCI).
- Neuropsychiatric disorders: Schizophrenia, bipolar disorder, and major depressive disorder.
Important Note
The purpose of this test is only to provide an initial assessment; additional tests are required for diagnostic screening.
What are Delirium and Dementia? What’s the difference between them?
Dementia is prevalent among the elderly and is similar to delirium in symptoms. According to the National Institute on Aging, a reputable source, fifty percent of people who are 85 years of age or older may have dementia.
The risk of future complications may be reduced if this condition is diagnosed and treated as soon as possible. Therefore, it is necessary to identify the similarities between the two.
This study is based on MEDICAL NEWS TODAY.
Comparison between Delirium & Dementia
| Delirium | Dementia |
|---|---|
| It means a sudden change in a person’s mental state, such as confusion, memory loss, or changes in their emotional or spiritual state. | It’s a broad term for losing many mental skills, such as the ability to remember things, speak clearly, think clearly, and solve problems. |
| Causes of Delirium: | Causes of Dementia: |
|---|---|
| Infections like pneumonia and UTI | Cerebrovascular disorders like strokes
|
| Chemical imbalances, e.g: acetylcholine or dopamine levels | Brain tumor |
| Use of certain medications | The gradual degeneration of brain cells |
| Brain tumors | Related to other medical conditions like HIV and Huntington’s disease |
| Head trauma | |
| Kidney or liver failure | |
| Alcohol, medicine, or drug abuse |
Types of Delirium and Dementia
| Different symptoms characterize the three forms of delirium | These are different types of dementia |
|---|---|
| Hypoactive Delirium: Feel tired or depressed or slow movement. | Lewy body Dementia |
| Hyperactive Delirium: Feel restless, agitated, or aggressive. | Frontotemporal Dementia |
| Mixed Delirium: Alternation between hypoactive and hyperactive states. | Vascular Disorders |
| Mixed dementia, or a combination of types | |
| Alzheimer’s or Parkinson’s disease | |
| Genetics, age, smoking and obesity |
Symptoms of Delirium and Dementia
| Delirium Sign & Symptoms | Dementia Sign & Symptoms |
|---|---|
| Confusion or disorientation | Memory loss |
| Memory loss | Confusion |
| Slurred speech or difficulty speaking coherently | Difficulty with speech |
| Difficulty concentrating | Difficulty with expressing thoughts |
| Hallucinations | Difficulty with reading and writing |
| Changes in sleep patterns | Difficulty with making judgments |
| Changes in mood or personality | Lost and disoriented in familiar areas |
| Repeating questions | |
| Describe familiar objects with unusual words | |
| A longer time to complete daily tasks | |
| Loss of interest in daily activities | |
| Hallucinations | |
| Paranoia | |
| Impulsiveness | |
| Losing balance | |
| Apparent changes in personality | |
| Mood changes |
Limitations of the AMT
AMT has certain limitations that should be considered when using it as a cognitive assessment tool.
Communication Barriers:
The test cannot be completed in patients with a reduced Glasgow Coma Scale (GCS) or language barriers. It’s important to note that not being able to complete the test does not equate to a score of 0; for example, a patient being French does not indicate delirium.
Frequently Asked Questions:
Why is a mental calculation test important in cognitive assessments?
Mental calculation tests assess a person’s ability to process information quickly and accurately, which is a key component of cognitive function. It can help identify cognitive impairments and provide valuable information for diagnosis and treatment planning for dementia or delirium.
Can the Abbreviated Mental Test diagnose dementia?
The test is not specifically designed to diagnose cognitive impairment; rather, it is a screening tool that can identify the condition. In order to confirm conditions such as dementia, additional evaluation is required.
How long does it take to complete the Abbreviated Mental Test?
Administering the test usually takes about 5-10 minutes, so it’s fast and efficient for initial cognitive screening.
Is the Abbreviated Mental Test (AMT) suitable for all age groups?
The test is mostly meant for older people, especially those who are showing signs of cognitive decline. Without modifications, it might not be appropriate for younger adults or children.
