Resources for the Comprehensive Geriatric Assessment based
Proactive and Personalised Primary Care of the Elderly
4AT
4 A's Test
Purpose : Rapid assessment test for delirium
Admin time : 3 min.
User Friendly : High
Administered by : GP or nurse
Content : The 4AT has 4 items, each of which begins with an ‘A’:
[1] Alertness
[2] AMT4: Abbreviated Mental Test - 4.
[3] Attention test: Months of the Year Backwards
[4] Acute change or fluctuating course
Author : Prof Alasdair MacLullich (Edinburgh Delirium Research Group, University of Edinburgh, Edinburgh, Scotland), and Dr Tracy Ryan and Dr Helen Cash (NHS Lothian, Scotland), 2011
Revised 2014 (version 1.2)
Copyright : free to use (https://www.the4at.com/)
Translations : available in several languages access
4AT
4AT
Advantages:
The 4AT was designed specifically for routine clinical use. It has features that mean that it can readily be implemented in day to day practice:
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short
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simple
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no special training needed
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built-in cognitive testing
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gives a clinically informative 4AT score, not an Unable To Assess (UTA), in patients too sleepy or restless for cognitive testing or interview
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good sensitivity and specificity
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effective in practice: detects delirium at the expected level
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no registration or permissions needed
Disadvantages:
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Patients suffering from dementia or confusion may react to the test with strong emotional reactions, such as irritation, frustration, anxiety, and anger.
Accuracy :
sensitivity 88% and specificity 88% (Tiegers Z, 2021)
This Tool is used in Delirium
Back To : Delirium
Delirium is one of 4 sub-domains of the
Psychological Assessment
Back To : Psychological Assessment
The Psychological Assessment is one of 8 domains of the
Comprehensive Geriatric Assessment (CGA)
Back To : Comprehensive Geriatric Assessment