miniCOG - dementia screening test

Last reviewed 01/2018

The Mini-Cog test is a 3-minute instrument to screen for cognitive impairment in older adults in the primary care setting

  • the Mini-Cog, a composite of three-item recall and clock drawing, was developed as a brief test for discriminating demented from non-demented persons in a community sample of culturally, linguistically, and educationally heterogeneous older adults
  • the Mini-Cog uses a three-item recall test for memory and a simply scored clock-drawing test (CDT). The latter serves as an "informative distractor", helping to clarify scores when the memory recall score is intermediate
  • the Mini-Cog was as effective as or better than established screening tests in both an epidemiologic survey in a mainstream sample and a multi-ethnic, multilingual population comprising many individuals of low socioe conomic status and education level
  • in comparative tests, the Mini-Cog was at least twice as fast as the Mini-Mental State Examination. The Mini-Cog is less affected by subject ethnicity, language, and education, and can detect a variety of different dementias. Moreover, the Mini-Cog detects many people with mild cognitive impairment (cognitive impairment too mild to meet diagnostic criteria for dementia)
1. Get patient's 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 are examples of word lists that have been validated in a clinical studies:

    • Version 1
      • Banana
      • Sunrise
      • Chair

    • Version 2
      • Village
      • Kitchen
      • Baby

    • Version 3
      • Captain
      • Garden
      • Picture
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 12 (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.  


Score 1 point for each recalled word

Score clock drawing as Normal (the patient places the correct time and the clock appears grossly normal) or Abnormal

  • 0 - Positive for cognitive impairment

  • 1-2 - Abnormal clock drawing test (CDT) then positive for cognitive impairment

  • 1-2 - Normal CDT then negative for cognitive impairment

  • 3 - Negative screen for dementia (no need to score CDT)


  • Borson 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.
  • 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.