The Six Item Cognitive Impairment Test (6-CIT) as a Screening Test for Dementia: Comparison with Mini-Mental State Examination (MMSE)

Abstract

The UK national Dementia Strategy clearly outlines a case for early detection and diagnosis of dementia. There is thus a need for a brief screening test for dementia in primary care, which can be administered and scored easily. To compare the performance of two cognitive scales, Mini-Mental State Examination (MMSE) and 6 Item Cognitive Impairment Test (6-CIT), as screening test for dementia in a naturalistic setting. 209 subjects referred to Old Age Psychiatry service were retrospectively studied. Their MMSE and 6-CIT scores were used to compare sensitivity, specificity and the Receiver Operating Characteristic (ROC) Curves for diagnosis of dementia. The correlation between the MMSE score and 6-CIT score is - 0.822. The MMSE has a sensitivity of 79.7% and specificity of 86.4% (cut-off 23/24). The 6-CIT has a sensitivity and specificity of 82.5% and 90.9% respectively (cut-off 10/11). The sensitivity of the 6-CIT increases to 90.2% at a lower cut-off of 9/10, but the corresponding specificity drops to 83.3%. The 6-CIT is a brief and simple test of cognition, which correlates reasonably well with the MMSE in a naturalistic setting. Compared with the MMSE it performs well as a screening instrument for dementia, which makes it a more appropriate test for primary care usage.