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Time to routinely perform 4AT at the ‘front door’; evidence informing policy and practice
Judith S.L. Partridge, Jugdeep K. Dhesi. Age and Ageing, 2025-08-01
Topic: Risk, prevention and care in population studies
A positive 4AT (≥1) on admission demonstrated a sensitivity of 0.87 and specificity of 0.71 when compared to a clinical diagnosis of dementia. Whilst these results suggest that 4AT is a sensitive and specific screening tool for dementia, false negatives still occur in 1 in 8 patients, reinforcing the need for clinical assessment. These results in a defined geographical area (Lothian) and nationally in a high risk patient population (hip fracture) are to be lauded.
Key findings
- A positive 4AT (≥1) on admission demonstrated a sensitivity of 0.87 and specificity of 0.71 when compared to a clinical diagnosis of dementia.
- Whilst these results suggest that 4AT is a sensitive and specific screening tool for dementia, false negatives still occur in 1 in 8 patients, reinforcing the need for clinical assessment.
- These results in a defined geographical area (Lothian) and nationally in a high risk patient population (hip fracture) are to be lauded.
Why it matters
This study found that a positive 4AT score on admission had a sensitivity of 0.87 and specificity of 0.71 compared with a clinical diagnosis of dementia, though false negatives still occurred in about 1 in 8 patients. The findings support the 4AT as a screening tool and reinforce the need for clinical assessment, not any treatment or cure.
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Study details
- Study designcohort study
- Participants221
- Effect size1.9%; 12.5%
- Evidence strengthModerate
How this study scored 52/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Age and Ageing) |
| Journal's citation record | 2 / 4 | Age and Ageing: journal h-index 231 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 221 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 1 / 6 | Cited 0.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Jugdeep K. Dhesi: h-index 36 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University College London: institution h-index 2,029 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40753535) |
| Free to read | 2 / 2 | Free to read |
| Total | 52 / 100 | — |
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Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Partridge, J. S., & Dhesi, J. K. (2025). Time to routinely perform 4AT at the ‘front door’; evidence informing policy and practice. Age and Ageing. https://doi.org/10.1093/ageing/afaf213
Vancouver
Partridge JS, Dhesi JK. Time to routinely perform 4AT at the ‘front door’; evidence informing policy and practice. Age and Ageing. 2025. doi:10.1093/ageing/afaf213. PMID: 40753535.
BibTeX
@article{partridge2025-40753535,
author = {Partridge, Judith S.L. and Dhesi, Jugdeep K.},
title = {{Time to routinely perform 4AT at the ‘front door’; evidence informing policy and practice}},
journal = {Age and Ageing},
year = {2025},
doi = {10.1093/ageing/afaf213},
pmid = {40753535},
url = {https://doi.org/10.1093/ageing/afaf213}
}
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