Abbreviated Mental Test Score (AMTS) - Department of Health

Tool and Resource Evaluation Template 

Adapted by NARI from an evaluation template created by Melbourne Health. 

Some questions may not be applicable to every tool and resource. 

Name and purpose Name of the resource: Abbreviated Mental Test (AMT) 

Target audience 

(the tool is to be 

used by) 

Target 

population/setting 

(to be used on/in) 

Please state why the resource was developed and what gap it proposes to fill: 

The Abbreviated Mental Test (AMT) was developed in 1972 and was designed to screen for 

cognitive impairment in hospitalised people 1 . 

Please check all that apply: 

Health service users Carers 

Medical staff Nursing staff Any member of an interdisciplinary team 

Medical specialist, please specify: 

Specific allied health staff, please specify: 

Other, please specify: 

Is the resource targeted for a specific setting? Please check all that apply: 

Emergency Department Inpatient acute Inpatient subacute Ambulatory 


For which particular health service users would you use this resource (e.g. a person with 

suspected cognitive impairment)? 

An Australian study 2 concluded that the AMT is an appropriate ‘screening instrument’ for dementia, 

in defined clinical settings, including: 

� Patients admitted to acute geriatric medical units 

� Patients over 75 years of age admitted to acute teaching hospitals 

� Patients being seen by geriatric liaison teams in acute teaching hospitals 

� Persons being reviewed by Aged Care Assessment Services (ACAS) 

� Older persons seeking residential care 

Structure of tool Website Education package Video 

Availability and 

cost of tool 

Applicability to 

rural settings and 

culturally and 

linguistically 

diverse 

populations 

Pamphlet Assessment tool Screening tool 

Methodology Resource guide Awareness raising resource (posters etc.) 


Please state the size of the resource (e.g. number of pages, minutes to read): 

The AMT is a 10-item tool, which must be administered as a set. Maximum score is 10, and a 

score of 7 or less is suggestive of cognitive impairment 1 . 

Is the resource readily available? Yes No Unknown Not applicable 

Is there a cost for the resource? Yes No Unknown Not applicable 

Please state how to get the resource: 

See: http://www.bmj.com/cgi/content/full/313/7055/465 

The AMT can be reproduced from the original validation study 1 . It is also available from a 1996 

study of doctors’ use of the tool 3 , which showed that there is considerable variation in the 

administration and scoring of the tool. 

Is the resource suitable for use in rural health services (e.g. the necessary staff are usually 

available in rural settings)? Yes No Unknown Not applicable 

Is the resource available in different languages? 

Yes No Unknown Not applicable 

Is the content appropriate for different cultural groups? 


There is limited research into the cultural appropriateness of cognitive screening. Some authors 

have suggested that older people from culturally and linguistically diverse (CALD) backgrounds

Person-centred 

principles 

Training 

requirements 

Administration 

details 

Data collection and 

analysis 

Sensitivity and 

specificity 

Face Validity 

Reliability 

have poorer ‘test-taking’ skills and may experience greater anxiety about cognitive assessment. 

Others conclude that although cultural bias is common in screening tests for cognition, sensitive 

administration and interpretation of results can minimise the effects 4-6 . 

There are questions in the AMT which are not necessarily appropriate to CALD groups – e.g. ‘date 

of First World War’ may vary according to your country of origin and may be a less significant event 

for people of non-European background; similarly ‘name of the current monarch’ may be affected 

by cultural background. 

However modified/culturally-adapted versions do exist, which show good sensitivity and specificity. 

The issue is that adapting a tool can significantly change it’s performance and validation studies 

need to be conducted within the target population on new versions. 7 

Does the resource adhere to/promote person-centred health care? 


Cognitive screening instruments have been criticised for failing to take into account educational 

level, cultural background, literacy, and proficiency in English; which would suggest they are not 

person-centred tools. However, it could be argued that without an assessment of cognitive status 

patients/clients cannot be provided with care that is designed to meet their needs. 

It is important that administration of all cognitive assessment instruments is performed by a person 

trained in their use, and who is cognisant of their shortcomings; and that interpreters and patient 

liaison staff are utilised as necessary. 

Is additional training necessary to use the resource? 


If applicable, please state how extensive any training is, and what resources are required: 

Whilst no formal training is required to use this instrument, it is advisable that users are familiar 

with the tool and the process for administration, in order to produce reliable results. 

How long does the resource take to use? 0-5 mins 5-15 mins 15-25mins 25mins 

Can the resource be used as a standalone, or must it be used in conjunction with other 

tools, resources, and procedures? 

Standalone 

Must be used with other resources, please specify: 

Can be used with other tools, please specify: 

Are additional resources required to collect and analyse data from the resource? 


If applicable, please state any special resources required (e.g. computer software): 

Sensitivity is the proportion of people that will be correctly identified by the tool. 

Specificity is the probability that an individual who does not have the condition being tested 

for will be correctly identified as negative. 

Has the sensitivity and specificity of the resource been reported? 


If applicable, please state what has been reported: 

A cut-off score of 7 and 8 provides the greatest sensitivity and specificity 8 . 

It is important to note that changing the questions and/or omitting certain questions – an apparently 

common practice – will affect the reliability, validity, and sensitivity of the AMT 3 . 

There is some evidence to suggest that the AMT can be used to identify post-operative delirium, in 

those aged 65+, if the tool is administered to patients on the day before and third day after their 

surgery 9 . A decline of 2 or more points in AMT score post-operatively is suggestive of delirium 

(sensitivity 93%; specificity 84%). 

Does the resource appear to meet the intended purpose? 


Correlates well with other cognitive assessment tools 10 

Reliability is the extent to which the tool’s measurements remain consistent over repeated 

tests of the same subject under identical conditions. Inter-rater reliability measures 

whether independent assessors will give similar scores under similar conditions.

Strengths 

Limitations 

References and 

further reading 

Has the reliability of the resource been reported? 


If applicable, please state what has been reported: 

The AMT has been shown to correlate well with other measures of cognition and can reliably rule 

out dementia (but does not diagnose it) 2,10 ; it also demonstrates high internal consistency 8 . The 

AMT has been shown to be a more reliable indicator of cognitive impairment than clinical judgment 

for patients who score in the mid-range 11 

What are the strengths of the resource? Is the resource easy to understand and use? Are 

instructions provided on how to use the resource? Is the resource visually well presented 

(images, colour, font type/ size)? Does the resource use older friendly terminology (where 

relevant), avoiding jargon? 

Please state any other known strengths, using dot points: 

• Patients do not have to read, write, or draw anything to complete test, and so completion 

of the AMT is not affected by visual impairment, which is a common problem in older 

people. 

• The AMT is quick and simple to use and is a more reliable indicator of cognitive 

impairment than clinical judgment for scores in the mid-range. 

What are the limitations of the tool/resource? Is the tool/resource difficult to understand 

and use? Are instructions provided on how to use the tool/resource? Is the tool/resource 

poorly presented (images, colour, font type/ size)? Does the tool/resource use difficult to 

understand jargon? 

Please state any other known limitations, using dot points: 

• Certain items such as ‘name of the monarch’ and ‘date of First World War’ are potentially 

less appropriate than they were when the AMT was developed, and this may affect its 

validity. 

Supporting references and associated reading. 

1. Hodkinson HM. Evaluation of a mental test score for assessment of mental impairment in 

the elderly. Age & Ageing, 1972;1(4):233-8. 

2. Flicker L, LoGiudice D, Carlin JB, Ames D. The predictive value of dementia screening 

instruments in clinical populations. International Journal of Geriatric Psychiatry, 

1997;12(2):203-9. 

3. Holmes J, Gilbody S. Differences in use of abbreviated mental test score by geriatricians 

and psychiatrists. BMJ, 1996;313(7055):465-. 

4. Parker C, Philp I, Sarai M, Rauf A. Cognitive screening for people from minority ethnic 

backgrounds. Nursing Older People, 2007;18(12):31-6. 

5. Chiu HFK, Lam LCW. Relevance of outcome measures in different cultural groups - does 

one size fit all? International Psychogeriatrics, 2007;19(3):457-66. 

6. Lydall-Smith S, Moorhouse B. Culturally Approriate Dementia Assessment. Centre for 

Applied Gerontology, Bundoora Extended Care Centre, Victora. 1995. 

7. Parker C, Philp I. Screening for cognitive impairment among older people in black and 

minority ethnic groups. Age & Ageing, 2004;33(5):447-52. 

8. Jitapunkul S, Pillay I, Ebrahim S. The abbreviated mental test: its use and validity. Age & 

Ageing., 1991;20(5):332-6. 

9. Ni Chonchubhair A, Valacio R, Kelly J, O'Keefe S. Use of the abbreviated mental test to 

detect postoperative delirium in elderly people. British Journal of Anaesthesia, 

1995;75(4):481-2. 

10. Antonelli Incalzi R, Cesari M, Pedone C, Carosella L, Carbonin PU, Gruppo Italiano di 

Farmacovigilanza nell'Anziano. Construct validity of the abbreviated mental test in older 

medical inpatients. Dementia & Geriatric Cognitive Disorders., 2003;15(4):199-206. 

11. Burleigh E, Reeves I, McAlpine C, Davie J. Can doctors predict patients' abbreviated 

mental test scores? Age and Ageing, 2002;31(4):303-306.

Abbreviated Mental Test Score (AMTS) - Department of Health

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