WHAT IS THE 4AT?
The 4AT is a brief clinical instrument for delirium detection.
It was designed to be used as a pragmatic tool for use in areas where assessment for delirium is routinely needed.
The 4AT is validated, and is a standard part of clinical practice internationally.
The 4AT is free to download and use.
Key features of the 4AT:
♦ takes only 1-2 minutes
♦ suitable for use in normal clinical practice
♦ practical and simple
♦ no special training is required
♦ allows assessment of ‘untestable’ patients (that is, patients with severe drowsiness or agitation)
♦ includes brief cognitive tests
The 4AT is designed to be used by any health professional at first contact with the patient, and at other times when delirium is suspected. It incorporates the Months Backwards test and the Abbreviated Mental Test - 4 (AMT4), which are short tests for cognitive impairment. This provides basic cognitive testing, aimed at detecting moderate-severe cognitive impairment, alongside assessment for delirium. See the guidelines on the 4AT form for more information.
REFERENCES (INCLUDING VALIDATION STUDIES)
Disclaimer: responsibility for the interpretation of scores and any actions rests with the clinical team using the 4AT. As per accepted clinical practice, a diagnosis of delirium should always be made following clinical assessment by suitably qualified staff.
Website: Alasdair MacLullich.