Six-item cognitive impairment test (6-CIT)'s accuracy as a cognitive screening tool: best cut-off levels in emergency department setting

Francesco Salis; Daniela Pili; Manuel Collu; Luca Serchisu; Rosanna Laconi; Antonella Mandas

doi:10.3389/fmed.2023.1186502

Six-item cognitive impairment test (6-CIT)'s accuracy as a cognitive screening tool: best cut-off levels in emergency department setting

Front Med (Lausanne). 2023 Jul 21:10:1186502. doi: 10.3389/fmed.2023.1186502. eCollection 2023.

Authors

Francesco Salis¹, Daniela Pili², Manuel Collu¹, Luca Serchisu², Rosanna Laconi², Antonella Mandas^{1

2}

Affiliations

¹ Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
² University Hospital "Azienda Ospedaliero-Universitaria" of Cagliari, Cagliari, Italy.

Abstract

Background: Nowadays, elderly patients represent a significant number of accesses to the Emergency Department (ED). Working rhythms do not allow to perform complete cognitive analysis, which would, however, be useful for the health care. This study aims to define the optimal cut-off values of the six-item Cognitive Impairment Test (6-CIT) as a cognitive screening tool in ED.

Methods: This study included 215 subjects, evaluated at the Emergency Department of the University Hospital of Monserrato, Cagliari, Italy, from July to December 2021. The accuracy of 6-CIT as a cognitive screening tool was assessed by comparison with Mini Mental State Examination (MMSE).

Results: The correlation coefficient between the two tests was -0.836 (CI: -0.87 to -0.79; p < 0.0001), and 6-CIT showed AUC = 0.947 (CI: 0.908-0.973; p < 0.0001). The 8/9 6-CIT cut-off score presented 86.76% sensitivity (CI: 76.4-93.8) and 91.84% specificity (CI: 86.2-95.7), and Youden index for this score was 0.786.

Conclusion: Our study demonstrates that 6-CIT is a reliable cognitive screening tool in ED, offering excellent sensitivity and specificity with a 8/9 points cut-off score.

Keywords: 6-item cognitive impairment test; aging; cognitive impairment; emergency department; mini mental state examination; screening.