miniCOG - dementia screening test

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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)
INSTRUCTIONS FOR ADMINISTRATION SCORING/SPECIAL INSTRUCTIONS
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.  

Scoring:

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)

Reference:

  • 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.

Last reviewed 01/2018

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