Validity and Reliability of the 6-Item Cognitive Impairment Test for Screening Cognitive Impairment: A Review

O'Sullivan, Dawn; O’Regan, N; Timmons, Suzanne

doi:10.1159/000448241

Cited by 57 publications

(48 citation statements)

References 36 publications

(42 reference statements)

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“…It thus has obvious potential as a combined delirium/ CI screening tool. 6-CIT can ‘quickly and reliably’ detect cognitive impairment in ED [ 8 , 17 ]. It has been shown to detect prevalent delirium and predict incident delirium [ 18 , 19 ].…”

Section: Methodsmentioning

confidence: 99%

Validation of the 6-Item Cognitive Impairment Test and the 4AT test for combined delirium and dementia screening in older Emergency Department attendees

et al. 2017

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Backgroundscreening for cognitive impairment in Emergency Department (ED) requires short, reliable tools.Objectiveto validate the 4AT and 6-Item Cognitive Impairment Test (6-CIT) for ED dementia and delirium screening.Designdiagnostic accuracy study.Setting/subjectsattendees aged ≥70 years in a tertiary care hospital’s ED.Methodstrained researchers assessed participants using the Standardised Mini Mental State Examination, Delirium Rating Scale-Revised 98 and Informant Questionnaire on Cognitive Decline in the Elderly, informing ultimate expert diagnosis using Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria for dementia and delirium (reference standards). Another researcher blindly screened each participant, within 3 h, using index tests 4AT and 6-CIT.Resultof 419 participants (median age 77 years), 15.2% had delirium and 21.5% had dementia. For delirium detection, 4AT had positive predictive value (PPV) 0.68 (95% confidence intervals: 0.58–0.79) and negative predictive value (NPV) 0.99 (0.97–1.00). At a pre-specified 9/10 cut-off (9 is normal), 6-CIT had PPV 0.35 (0.27–0.44) and NPV 0.98 (0.95–0.99).Importantly, 52% of participants had no family present. A novel algorithm for scoring 4AT item 4 where collateral history is unavailable (score 4 if items 2–3 score ≥1; score 0 if items 1–3 score is 0) proved reliable; PPV 0.65 (0.54–0.76) and NPV 0.99 (0.97–1.00). For dementia detection, 4AT had PPV 0.39 (0.32–0.46) and NPV 0.94 (0.89–0.96); 6-CIT had PPV 0.46 (0.37–0.55) and NPV 0.94 (0.90–0.97).Conclusion6-CIT and 4AT accurately exclude delirium and dementia in older ED attendees. 6-CIT does not require collateral history but has lower PPV for delirium.

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Section: Methodsmentioning

confidence: 99%

Validation of the 6-Item Cognitive Impairment Test and the 4AT test for combined delirium and dementia screening in older Emergency Department attendees

et al. 2017

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“…Analysis of physical frailty included nutritional status [Mini Nutritional Assessment (MNA)], gait speed [Timed to Get up and Go Test (TUGT)], polypharmacy (five or more medicines), daily functioning (NAGI scale) and grip strength [11][12][13]. Screening for mental frailty included an assessment of cognition [six-item Cognitive Impairment Test (6-CIT)] and HRQL [Short Form 12 (SF-12)] [14,15]. To assess social frailty we evaluated a patient's living situation and social support system.…”

Section: Preoperative Frailty Screeningmentioning

confidence: 99%

Preoperative frailty and outcome in patients undergoing radical cystectomy

et al. 2020

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Objective To determine the value of preoperative frailty screening in predicting postoperative severe complications and 1‐year mortality in patients undergoing radical cystectomy (RC). Patients and Methods Prospective cohort single‐centre study in patients undergoing RC from September 2016 to December 2017. Preoperative frailty screening was implemented as standard care and was used to guide shared decision‐making during multidisciplinary team meetings. Frailty screening consisted of validated tools to assess physical, mental and social frailty. Patients were considered frail when having two or more frailty characteristics. The primary endpoint was the composite of a severe complication (Clavien–Dindo Grade III–V) within 30 days and 1‐year all‐cause mortality. The secondary endpoints included any complication (Clavien–Dindo II–V), length of stay, readmission within 30 days, and all‐cause mortality. Logistic regression analysis and the concordance statistic (c‐statistic) were used to describe the association and predictive value of preoperative frailty screening. Results A total of 63 patients were included; 39 (61.9%) were considered frail. Preoperative frailty was associated with a seven‐fold increased risk of a severe complication or death 1 year after RC [adjusted odds ratio (OR) 7.36, 95% confidence interval (CI) 1.7–31.8; 22 patients]. Compared to the American Society of Anesthesiologists (ASA) score and Charlson Comorbidity Index, frailty showed the best model performance (Nagelkerke R2 0.20) and discriminative ability(c‐statistic 0.72, P < 0.01) for the primary endpoint. After adding frailty to the conventional ASA risk score, the c‐statistic improved by 11% (P < 0.01). Overall survival was significantly worse in frail patients (23.2 months, 95% CI 18.7–30.1) vs non‐frail patients (32.9 months, 95% CI 30.0–35.9; P = 0.01). Conclusions Frail patients undergoing RC are at high risk of postoperative adverse outcomes including death. Preoperative frailty screening improves preoperative risk stratification and may be used to guide patient selection for RC.

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“…The BOMC performs similarly to the Mini-Mental Status Exam; however, some prefer the BOMC for its rapid and completely verbal administration. A score of greater than 9 is a sensitive screen for cognitive impairment [ 70 ].…”

Section: Methodsmentioning

confidence: 99%

Geriatric assessment for older adults with sickle cell disease: protocol for a prospective cohort pilot study

Oyedeji

Hall

Luciano³

et al. 2020

Pilot Feasibility Stud

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Background The life expectancy for people with sickle cell disease (SCD) has improved tremendously over the last 50 years. This population experiences hemolysis and vaso-occlusion in multiple organs that lead to complications such as cardiopulmonary disease, strokes, and avascular necrosis. These complications can limit mobility and aerobic endurance, similar to limitations that often occur in geriatric populations. These sickle-cell and age-related events lead to frequent hospitalization, which further increases the risk of functional decline. We have few tools to measure functional decline in people with SCD. The purpose of this paper is to describe a protocol to evaluate the feasibility of sickle cell disease geriatric assessment (SCD-GA). Methods/design We will enroll 40 adults with SCD (20 age 18–49.99 years and 20 age ≥ 50 years) in a prospective cohort study to assess the feasibility of SCD-GA. The SCD-GA includes validated measures from the oncology geriatric assessment enriched with additional physical and cognitive measures. The SCD-GA will be performed at the first study visit, at 10 to 20 days after hospitalization, and at 12 months (exit visit). With input from a multidisciplinary team of sickle cell specialists, geriatricians, and experts in physical function and physical activity, we selected assessments across 7 domains: functional status (11 measures), comorbid medical conditions (1 measure), psychological state (1 measure), social support (2 measures), weight status (2 measures), cognition (3 measures), and medications (1 measure). We will measure the proportion completing the assessment with feasibility as the primary outcome. Secondary outcomes include the proportion consenting and completing all study visits, duration of the assessment, acceptability, and adverse events. Discussion We present the protocol and rationale for selection of the measures included in SCD-GA. We also outline the methods to determine feasibility and subsequently to optimize the SCD-GA in preparation for a larger multicenter validation study of the SCD-GA.

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Validity and Reliability of the 6-Item Cognitive Impairment Test for Screening Cognitive Impairment: A Review

Cited by 57 publications

References 36 publications

Validation of the 6-Item Cognitive Impairment Test and the 4AT test for combined delirium and dementia screening in older Emergency Department attendees

Validation of the 6-Item Cognitive Impairment Test and the 4AT test for combined delirium and dementia screening in older Emergency Department attendees

Preoperative frailty and outcome in patients undergoing radical cystectomy

Geriatric assessment for older adults with sickle cell disease: protocol for a prospective cohort pilot study

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