Score, Scales and Assessments

Question 1

4AT

Answer 1

ASSESSMENT TEST FOR DELIRIUM AND COGNITIVE IMPAIRMENT

Question 2

RUDAS

Answer 2

THE ROWLAND UNIVERSAL DEMENTIA ASSESSMENT SCALE

Question 3

AMTS

Answer 3

Abridged mental test score

• 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)

Question 4

What questions / format is the AMTS?

Answer 4

10 questions

• 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

Question 5

What is CAM?

Answer 5

The Confusion Assessment Method.

The CAM is a valided method of diagnosing delirium
A positive or negative result depends on four criteria:
1. Acute onset and fluctuating course
Determined by collateral history or repeated clinic assessment

2. Inattention
   Counting from 20-1 is a simple (if blunt) test for this
3. Disorganised thinking
4. Altered levels of consciousness

The CAM is considered to be positive for the presence of delirium if both features 1 and 2 are present, with at least one of features 3 or 4.