dementia Screening test

[Music] hello I'm Dr Kevin Morgan consultant psychiatrist with mental health services for older people and the memory service here in rotheram this short video will demonstrate the use of the six item cognitive impairment test or 6 CIT this is a quick simple and widely used screening tool for the identification of patients with cognitive impairment using a cut off of eight or above it is also highly sensitive and specific to the detection of patients with dementia even at the milder end of the spectrum importantly it's also largely unaffected by educational level and language ability and so can be safely applied across the sort of population that we have here in Rotherham I'll now hand over to Dr Russell Bryan who will [Music] demonstrate hello I'm Russell bres the mental health lead for Ram clinical commissioning group I'm here to demonstrate how to conduct a 6 CIT as we will be aware patients will have different perceptions about what a test like this will mean for them some will be worried that it will mean they're mental or that they're starting with Dementia or that they won't be able to drive after we've done it it's best if we can explain that this is just part of the process of helping to find out what's the problem and that we will also need to do some further investigations later on it helps if we can have a relaxing atmosphere and give the patient time to think about the questions and answer them at their own speed some of the questions will seem strange uh some of the patients occasionally get insulted by being asked to recite numbers backwards or tell us what year it is so it's important that we reassure the patient and tell them that this test itself isn't definitive and we'll need to do uh some other tests before we can give them a diagnosis the first question is about orientation what year is it the exact year must be given however this could be as in 2016 or just 16 the patient will score0 for a correct answer or four for an incorrect answer good morning Mr Johnson good morning I'm Dr Bryant how are you today a bit nervous really oh really what are you nervous about oh this do you think I'm mental no no do you remember you came to tell me you were concerned that you had some problems with your memory yes and so what we're going to do today is a memory test and then after this I'm going to ask you to get some blood test done with the nurse and we're going to give you another questionnaire to take home and then we'll see you next weekend when we've got all the three things together and see whether there's any more we need to do to help you right is that okay y so let's start off and ask you what year is it um 2016 the second question is also about orientation what month is it again the exact month must be given but a number for instance 10 or October are both acceptable the patient will score 0 for a correct answer or three for an incorrect answer what month is it March the third question is the first part of the memory test the second part is to be completed after question six there are five parts to the memory test for example John Smith 42 High Street Bedford you can repeat this this up to three times to enable the patient to remember it if they're unable to remember after the third time a c is recorded now I'll give you a name and address to remember okay it's John Smith 42 High Street Bedford uh John Smith 42 High Street Bedford the fourth question is again about orientation and this time it's what time is it we'd ask them to tell us the time without looking at their watch and we're looking for an answer plus or minus an hour around the current time if the time is vague then it's possible to ask them to be a little more precise they score uh zero for a correct answer and three for an incorrect answer and now I'd like you to tell me what time it is um please without looking at your watch oh sorry uh about 11:00 I think the fifth question tests calculation ask the patient to count from 20 backwards if they make a mistake that's one error if they start to uh count forwards ask the patient to stop and repeat the instructions but that doesn't count as an error they score zero for uh correct answer two points for one error and four points for two errors this might sound a bit strange but I'd like you to count backwards from 20 down to one okay um 20 19 18 17 16 16 15 14 13 12 11 10 9 8 76 5 43 2 1 thank you the next question also test calculation and now we're going to ask the patient to say the months of the year backwards start in December when we ask them to do this we can give them a prompt and say December but if we do that counts as one error if the patient starts to count the months forwards we ask them to stop and repeat the question but that doesn't count as an error if the patient gets all the answers right they score zero if they get one error that's two points if they score two errors so that's four points and now I'd like you to tell me the months of the year backwards um December November October September August July June May April March February January we then perform the second part of the memory test do you remember I gave you an address to remember earlier yes could I ask you what that address was please um John Smith 42 High Street Bedford thank you very much and that's the end of the memory test now what I'd like you to do is go to reception and tell them you'd like to see the nurse for some blood tests and I'd also like to give you a questionnaire that you could take home and ask your husband to fill in and that's asking him to tell us what he thinks about the way you're managing at home and then if you make an appointment to see me in a week's time we'll have the results of the blood tests results from today and your husband's questionnaire and we'll see if there's any help that you need all right thank you doctor so that's how to conduct a 6 CIT as with all questionnaires it gets easy the more often you do it and I've certainly found it more useful than the old style of tell me who the queen is questioning thank you very [Music] much

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Length: 8min 47sec (527 seconds)

Published: Wed Jun 15 2016