Screening for cognitive impairment in older general hospital patients: comparison of the Six-Item Cognitive Impairment Test with the Mini-Mental State Examination

• Published in: International journal of geriatric psychiatry Vol. 27; no. 7; pp. 755 - 762
• Main Authors: Tuijl, Jolien P., Scholte, Evert M., de Craen, Anton J.M., van der Mast, Roos C.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.07.2012; Psychology Press; Wiley Subscription Services, Inc
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Cognition & reasoning; Cognition Disorders - diagnosis; Cognition Disorders - psychology; cognitive impairment; Comparative analysis; Female; General aspects; general hospital; Geriatric Assessment - methods; Geriatric psychiatry; Geriatrics; Higher education; Hospitals, General; Humans; Male; Mass Screening - instrumentation; Medical sciences; Medical screening; older patients; Older people; Predictive Value of Tests; Prevention and actions; Psychiatric Status Rating Scales - standards; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health. Hygiene; Public health. Hygiene-occupational medicine; risk factors; ROC Curve; Sensitivity and Specificity; Human; older patients; Mini Mental State Examination Folstein et al; risk factors; Cognitive disorder; General hospital; Psychology; Neuropsychological test; Hospitalization; Medical screening; Screening; Gerontology; Risk factor; cognitive impairment; Elderly; Psychiatry; Comparative study; Public health; Geriatrics
• ISSN: 0885-6230; 1099-1166
• DOI: 10.1002/gps.2776

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.