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Mini Cog Form

mini cog

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410 views

Mini Cog Form

mini cog

Uploaded by

Anonymous SVy8sOsvJD
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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MINI-COG

TM

Instructions
ADMINISTRATION

SPECIAL INSTRUCTIONS

1. Get patients attention and ask him or her


to remember three unrelated words. Ask
patient to repeat the words to ensure the
learning was correct.

Allow patient three tries, then go to next item.


The following word lists have been validated in a clinical study:13
Version 1
B anana
Sunrise
Chair

Version 3
V illage
Kitchen
Baby

Version 5
C aptain
Garden
Picture

Version 2
Daughter
Heaven
Mountain

Version 4
River
Nation
Finger

Version 6
Leader
Season
Table

2. Ask patient to draw the face of a clock.


After numbers are on the face, ask patient
to draw hands to read 10 minutes after
11:00 (or 20 minutes after 8:00).

Either a blank piece of paper or a preprinted circle (other side) may be used.
A correct response is all numbers placed in approximately the correct positions AND the
hands pointing to the 11 and 2 (or the 4 and 8).
These two specific times are more sensitive than others.
A clock should not be visible to the patient during this task.
Refusal to draw a clock is scored abnormal.
Move to next step if clock not complete within three minutes.

3. Ask the patient to recall the three words


from Step 1.

Ask the patient to recall the three words you stated in Step 1.

Scoring
3 recalled words
1-2 recalled words + normal CDT
1-2 recalled words + abnormal CDT
0 recalled words

Negative for cognitive impairment


Negative for cognitive impairment
Positive for cognitive impairment
Positive for cognitive impairment

References
1. B orson S, Scanlan J, Brush M, Vitaliano P, Dokmak A. The mini-cog: a cognitive vital signs measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry. 2000;15(11):1021-1027.
2. Borson S, Scanlan JM, Chen P, Ganguli M. The Mini-Cog as a screen for dementia: validation in a population-based sample. J Am Geriatr Soc. 2003;51(10):1451-1454.
3. McCarten JR, Anderson P Kuskowski MA et al. Finding dementia in primary care: the results of a clinical demonstration project. J Am Geritr Soc. 2012;60(2):210-217.
Mini-CogTM Copyright S Borson. Reprinted with permission of the author ([email protected]). All rights reserved.

800.272.3900 | alz.org

CLOCK DRAWING TEST


Patient Name:

800.272.3900 | alz.org

Date:

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