NOTES ON REVISIONS
VERSION 1.2 (CURRENT VERSION)
Version 1.2 was released in October 2014. Again, this updated version of the 4AT is unchanged from v1.0 or v1.1 with respect to the testing items and scoring. The updates involve changing the text "The 4 ‘A’s Test: screening instrument for delirium and cognitive impairment" (which was under the 4AT logo), to "Assessment test for delirium & cognitive impairment". This is because the word "screening" has different meanings in different contexts, and to avoid this problem we have decided to describe the 4AT as an "assessment test". There are also some slight formatting changes, and the addition of this text: "© 2011-2014 MacLullich, Ryan, Cash". The addition of the copyright statement does not in any way change our policy of allowing free downloads, use and copying as required for non-commercial clinical or research use.
Version 1.1 was released in May 2014. This updated version of the 4AT is unchanged from the original with respect to the testing items and scoring. The updates involve the interpretation of a score of zero on the 4AT, and the guidance notes. Regarding a score of zero, version 1.0 stated: 'delirium or cognitive impairment [is] unlikely'. Version 1.1 states that a score of zero suggests that 'delirium or severe cognitive impairment [is] unlikely'. This change was made because some people who show no errors on both Months Backwards (to 7 months) and the AMT4 may show some cognitive impairment when tested using more detailed and longer assessments. This issue also applies to other brief cognitive screening tests, eg. the 10-item Abbreviated Mental Test and the Mini-Mental State Examination. Note that the change to the interpretation of a score of zero in version 1.1 applies only to the detection cognitive impairment, not to delirium.