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The Abbreviated Mental Test Score; Is There a Need for a Contemporaneous Update?
INTRODUCTION: Designed in 1972 the Abbreviated Mental Test Score (AMTS) is widely used to assess a cognition on hospital admission. The Nottingham Hip Fracture Score uses this in predicting morbidity/mortality in neck of femur fracture. The consequences of misappropriating cognitive impairment could...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8634377/ https://www.ncbi.nlm.nih.gov/pubmed/34868721 http://dx.doi.org/10.1177/21514593211001047 |
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author | Peters, Kizzie A. Howe, Thomas J. Rossiter, Daniel Hutchinson, Kirsty J. Rosell, Philip A. |
author_facet | Peters, Kizzie A. Howe, Thomas J. Rossiter, Daniel Hutchinson, Kirsty J. Rosell, Philip A. |
author_sort | Peters, Kizzie A. |
collection | PubMed |
description | INTRODUCTION: Designed in 1972 the Abbreviated Mental Test Score (AMTS) is widely used to assess a cognition on hospital admission. The Nottingham Hip Fracture Score uses this in predicting morbidity/mortality in neck of femur fracture. The consequences of misappropriating cognitive impairment could have lasting implications. Questions about the monarchy or World War One and Two may be inappropriate for today’s diverse society. MATERIALS AND METHODS: 100 patients were questioned during routine fracture clinic appointments. Patients were asked: In what year did WWII start? Who is the current monarch? Please state a memorable event in your lifetime that you would not expect another person of the same age to forget. Two-tailed Z-tests were performed between the observed proportions and those from the original AMTS validation study. RESULTS: Only 47% (n = 47) were able to correctly answer the year in which WW2 started. A statistically significant difference when compared to the upper and lower limits from the original study (z = -4.191, p < .001.). Significance was not seen in the second question, with 97% (n-97) identifying the monarch correctly. 51% (n = 51) of participants suggested the terrorist attack on the World Trade Centre in New York as an alternative memorable event. DISCUSSION: Some hospitals now use the 4 “A”s Test (4-AT) as a screening tool for delirium. Without amendments to the Nottingham Hip Fracture Score, AMTS use is likely to continue in orthogeriatric patients. Over time there will be a need for the AMTS to be reviewed so that it remains a true assessment of cognition. Its limitations regarding language and culture is widely acknowledged and several validated variants have been published in the literaure. CONCLUSIONS: We highlight a potential future issue with the AMTS and raise considerations for the development of an alternative question to better meet the needs of the orthogeriatric population. |
format | Online Article Text |
id | pubmed-8634377 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-86343772021-12-02 The Abbreviated Mental Test Score; Is There a Need for a Contemporaneous Update? Peters, Kizzie A. Howe, Thomas J. Rossiter, Daniel Hutchinson, Kirsty J. Rosell, Philip A. Geriatr Orthop Surg Rehabil Resident Corner INTRODUCTION: Designed in 1972 the Abbreviated Mental Test Score (AMTS) is widely used to assess a cognition on hospital admission. The Nottingham Hip Fracture Score uses this in predicting morbidity/mortality in neck of femur fracture. The consequences of misappropriating cognitive impairment could have lasting implications. Questions about the monarchy or World War One and Two may be inappropriate for today’s diverse society. MATERIALS AND METHODS: 100 patients were questioned during routine fracture clinic appointments. Patients were asked: In what year did WWII start? Who is the current monarch? Please state a memorable event in your lifetime that you would not expect another person of the same age to forget. Two-tailed Z-tests were performed between the observed proportions and those from the original AMTS validation study. RESULTS: Only 47% (n = 47) were able to correctly answer the year in which WW2 started. A statistically significant difference when compared to the upper and lower limits from the original study (z = -4.191, p < .001.). Significance was not seen in the second question, with 97% (n-97) identifying the monarch correctly. 51% (n = 51) of participants suggested the terrorist attack on the World Trade Centre in New York as an alternative memorable event. DISCUSSION: Some hospitals now use the 4 “A”s Test (4-AT) as a screening tool for delirium. Without amendments to the Nottingham Hip Fracture Score, AMTS use is likely to continue in orthogeriatric patients. Over time there will be a need for the AMTS to be reviewed so that it remains a true assessment of cognition. Its limitations regarding language and culture is widely acknowledged and several validated variants have been published in the literaure. CONCLUSIONS: We highlight a potential future issue with the AMTS and raise considerations for the development of an alternative question to better meet the needs of the orthogeriatric population. SAGE Publications 2021-03-11 /pmc/articles/PMC8634377/ /pubmed/34868721 http://dx.doi.org/10.1177/21514593211001047 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Resident Corner Peters, Kizzie A. Howe, Thomas J. Rossiter, Daniel Hutchinson, Kirsty J. Rosell, Philip A. The Abbreviated Mental Test Score; Is There a Need for a Contemporaneous Update? |
title | The Abbreviated Mental Test Score; Is There a Need for a Contemporaneous Update? |
title_full | The Abbreviated Mental Test Score; Is There a Need for a Contemporaneous Update? |
title_fullStr | The Abbreviated Mental Test Score; Is There a Need for a Contemporaneous Update? |
title_full_unstemmed | The Abbreviated Mental Test Score; Is There a Need for a Contemporaneous Update? |
title_short | The Abbreviated Mental Test Score; Is There a Need for a Contemporaneous Update? |
title_sort | abbreviated mental test score; is there a need for a contemporaneous update? |
topic | Resident Corner |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8634377/ https://www.ncbi.nlm.nih.gov/pubmed/34868721 http://dx.doi.org/10.1177/21514593211001047 |
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