6-CIT: Six-Item Cognitive Impairment Test

Abstract

The Six-item Cognitive Impairment Test (6-CIT) was designed to assess global cognitive status in dementia. Developed in the 1980s as an abbreviated version of the 26-item Blessed Information-Memory-Concentration Scale, the 6-CIT is an internationally used and well-validated screening tool for use in primary care. In recent years, it has been compared favorably to the Mini-Mental State Examination (MMSE) due to its brevity and ease of use, although it is still less widely used than the MMSE. Some evidence suggests that it outperforms the MMSE as a screening tool for dementia, especially in its mildest stage. The 6-CIT has been translated into many different languages. It comprises 6 questions: one memory (remembering an address), two calculations (recalling numbers and months backward), and three orientations (e.g. time of day, month, and year). The time taken to administer the scale is approximately 2 min, which compares favorably to other scales. However, this brevity has also been seen as disadvantageous, with the suggestion that more ­features of dementia can be detected in more comprehensive screening tools. Criticisms that the scoring system is too complex have been raised, but plans for the 6-CIT to be distributed with computer software could go some way to resolving this. In summary, the 6-CIT is a brief, validated screening tool that may be preferable to the currently, and more widely, used MMSE. Since a typical UK primary care consultation stands at only 7.5 minutes, the brevity and simplicity of the scale are its greatest advantages.