The Abbreviated Mental Test Score (AMTS) is a 10-point test designed for the rapid assessment of elderly patients for potential dementia. It is recommended as the primary screening tool in emergency and hospital settings for patients over 65. First introduced in 1972, it is now also utilized to assess mental confusion (including delirium) and other cognitive impairments. The test takes approximately 34 minutes to administer and requires no specialist training or licensing.
History
The AMTS was developed to address the need for a rapid, practical method of assessing cognitive impairment in geriatric patients. In 1972, Hodkinson adapted it from the 26-item Blessed Dementia Scale (BDS) by removing 16 items: 13 for repetitiveness, 2 for being too easy, and 1 for being too difficult. although further and more formal tests are necessary to confirm a diagnosis of dementia, delirium or other causes of cognitive impairment. Culturally-specific questions may vary based on region.
As no formal administration training is required, many clinicians administer and score the AMTS incorrectly. Score cut-off thresholds for cognitive impairment vary widely from 6–10, undermining the test's diagnostic reliability.
Shorter Versions
The AMT4 uses 4 items from the AMTS, with a cut off score of 3 or 4 compared to the usual 8 or 9. The AMT4 is part of the 4AT scale for delirium. The AMT5 as it relies on UK-specific knowledge, such as naming the current Monarch. IQCODE, SPMSQ, and the frequently used MMSE in general hospital settings by exhibiting high diagnostic accuracy, ease of use, and brevity.
However, the AMTS is less effective at detecting mild cognitive impairment, missing over half of cases compared to the MoCA which provides a more comprehensive cognitive profile. with most versions using similar cut-off scores to identify cognitive impairment.
In Thailand, the AMTS was adapted by replacing the World War I question with the date of the Great Sorrow, the Monarch's name with the Thai King, and the address recall task with the patient's current address. The last change aimed to reflect cultural norms, as most rural elderly individuals are unfamiliar with memorising arbitrary information like made-up addresses. This alteration has been criticised for shifting the task from testing short-term memory to semantic memory.
Despite these adaptations, the Thai AMTS shows high rates of false-negative diagnoses. Many older adults were unable to provide their birth date or recall the current year due to Thailand's mixed lunar/solar calendar system. These issues highlight the cultural limitations of the AMTS and the need for further adaptation in Thailand.
See also
- General Practitioner Assessment Of Cognition
- GERRI
- Mini-Mental State Examination