Validation of a 6 Item Cognitive Impairment Test with a View to Primary Care Usage

Objective: To validate the 6 Item Cognitive Impairment Test (6CIT) against the Mini-Mental State Exam (MMSE) with a view to usage as a screening tool.

Design: Three groups with varying levels of dementia were tested using the MMSE, 6CIT and Global Deterioration Scale (GDS).

Setting: Testing was carried out within Wiltshire, both in the community and outpatients.

Subjects: Patients were selected from a hospital database of dementia patients and were stratified into two groups according to GDS; a control group was also tested.

Results: Two hundred and eighty-seven patients were tested: 135 controls (GDS 1-2), 70 with mild dementia (GDS 3-5) and 82 with more severe dementia (GDS 6-7). The 6CIT and MMSE were found to correlate well, r(2)=-0.911 (p<0.01), when all groups were analysed. Correlation falls to r(2)=-0.754 (p<0.01) in the mild dementia group. In the GDS 3-5 group, the MMSE has a sensitivity and specificity of 51.43% and 100% respectively (cutoff 23/24). The 6CIT gives a sensitivity and specificity of 78.57% and 100% (cutoff 7/8).

Conclusion: The 6CIT is a brief and simple test of cognition, which correlates well with the MMSE but outperforms it in milder dementia. The MMSE is of little value as a screening test for dementia.