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Abbreviated Mental Test Score (AMTS)

 

Definition of the Abbreviated Mental Test Score (AMTS)

  • The AMTS was developed and validated by Hodgkinson in 1972 (and later 1974 for institutionalised patients)
  • It is a useful tool for determining the presence of cognitive impairment in a patient
  • Initially developed to pick up the presence of dementia, now commonly used to identify any confusion (acute or chronic)

 

 The questions in the AMTS (1 point each)

  • Age
  • Current time (to the nearest hour)
  • Recall: Ask the patient to remember an address (e.g. 42 West Register Street)
    • Ensure they are able to say it back to you immediately, then check recall at the end of the test
  • Current year
  • Current location (e.g. name of hospital or town)
  • Recognise two people (e.g. relatives, carers, or if none around, the likely profession of easily identified people such as doctor/nurse)
  • Date of birth
  • Years of the first (or second) world war
  • Name of the current monarch (or prime minister)
  • Count sequentially backwards from 20 to 1
    • A score of less than 8 in the AMTS implies the presence of cognitive impairment

 

 Limitations of the AMTS

  • In a patient with reduced GCS (or language barrier) the test cannot be completed
    • However, this does not give them a score of 0: being French is not a cause of delirium
  • The test was validated during the 1970s in the elderly population
    • As such, the first world war was a significant life event, that one would expect any elderly patient to recall
    • With worrying frequency, younger patients are unable to recall the dates of the world wars, or tell you the name of the current monarch, already leaving them with a score of 8/10
  • It does remain a useful initial screening tool, with high sensitivity, to identify elderly patients with cognitive impairment (e.g. delirium or dementia)

 

 Click here to download free teaching notes on the Abbreviated Mental Test Score (AMTS): Geriatrics – AMTS

Perfect revision for medical students, finals, OSCEs and MRCP PACES