Which of the following is a good example of a person with an impairment of orientation?

Purpose

The OMCT is a 6-item measure of cognitive impairment based on the Blessed Test.

Acronym OMCT

Area of Assessment

Attention & Working Memory
Cognition
Executive Functioning
Reasoning/Problem Solving

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

• A short assessment of cognitive ability composed of 6 items.
• The clinician reads the following directions to patients:
  "Now I would like to ask you some questions to check your memory and concentration. Some of the questions may be easy and some of them may be hard, but please try to answer them all."
• Scoring:
  0 - 8: Normal-minimum impairment
  9 - 19: Minimal to Moderate impairment
  20 - 28: Severe impairment

  A score from 0 - 8 is within normal limits.

Required Training

No Training

Measurement Domain

Cognition

Considerations

Considerations: (Parker & Philp, 2004)

• OMC scores are related to level of educational attainment
• Specificity in African American groups has been reported to be low
• The OMC seems to assess changes in verbal memory

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Cut-Off Scores

Alzheimer's Disease: (Davous et al, 1987; n = 133; mean age = 64.5 (range = 37 to 91) years; multiple diagnosis)

• >10 indicates cognitive impairment

• Sensitivity = 88%
• Specificity = 94%
• False positive = 11%
• False negative = 5%

Normative Data

Alzheimer's Disease: (Davous et al, 1987) 

Test/Retest Reliability

Alzheimer's: (Fuld, 1978; n = 18 patients)

• Retesting 3 weeks after the initial assessment resulted in a score within 4 points of the original score.

Criterion Validity (Predictive/Concurrent)

Alzheimer's Disease: (Davous et al, 1987)

• OMCT appeared equivalent to the Mini Mental State Examination in identifying dementia

Construct Validity

Alzheimer's: (Davous et al, 1987; n =  21 patients during the same week as the mental status evaluation by a trained psychologist blind to OMCT results)

• Adequate: Wechsler Memory Scale (Pearson r = - 0.562, p < 0.01)
• Adequate: Progressive Matrices; Raven PM47 (Spearman r = 0.590, p < 0.01)

Minimal Detectable Change (MDC)

Various Neurological Diseases: (Wade & Vergis, 1998; n = 38; mean age = 47.1 (11.4) years)

• improvement greater than 6 points were found to indicate a real improvement in memory
• deterioration of more than 2 points represented real declines

Criterion Validity (Predictive/Concurrent)

Nursing home patients: (Katzman 1983; n = 170, demographic details not indicated)

• Excellent correlations with the full Blessed test (r = 0.941)
• In a separate sample composed of patients suffering from dementia; 81 % of the population had scores within +/- 4 of total Blessed scores

Construct Validity

Various Neurological Diseases: (Wade & Vergis, 1998)

• No clinically significant differences between OMC scores and Barthel ADL scores (Pearson’s r = 0.23)

Content Validity

Stepwise regression of the 26 item Blessed measure revealed 5 items with high item-total correlations. These items were then used to create the final 6 item measure.

Bibliography

Davous, P., Lamour, Y., et al. (1987). "A comparative evaluation of the short orientation memory concentration test of cognitive impairment." J Neurol Neurosurg Psychiatry 50(10): 1312-1317. Find it on PubMed

Fuld, P. (1978). "Psychological testing in the differential diagnosis of the dementias." Alzheimer’s disease: senile dementia and related disorders 7.

Katzman, R., Brown, T., et al. (1983). "Validation of a short Orientation-Memory-Concentration Test of cognitive impairment." Am J Psychiatry 140(6): 734-739. Find it on PubMed

Parker, C. and Philp, I. (2004). "Screening for cognitive impairment among older people in black and minority ethnic groups." Age Ageing 33(5): 447-452. Find it on PubMed

Wade, D. T. and Vergis, E. (1999). "The Short Orientation-Memory-Concentration Test: a study of its reliability and validity." Clin Rehabil 13(2): 164-170. Find it on PubMed