4AT Assessment

[1] ALERTNESS

Observe the patient. If asleep, attempt to wake.

Normal

Fully alert, not agitated.

Mild sleepiness

<10s sleepiness after waking.

Clearly abnormal

Drowsy, difficult to rouse, or agitated.

[2] AMT4

Age, DoB, Place, Current Year.

No mistakes (0)

1 mistake (+1)

2+ mistakes / Untestable (+2)

[3] ATTENTION

Months of the year backwards.

7+ months correctly (0)

Starts but <7 correct (+1)

Untestable (+2)

[4] ACUTE CHANGE / FLUCTUATION

Significant changes or fluctuations in alertness or cognition in last 2 weeks, and still evident in last 24 hours. E.g. paranoia, hallucinations

No (0)

Yes (+4)