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Mental Status Scales
| 10 Select Mental Status Scales | Pages |
|---|---|
| SHORT (≤5 minutes) | |
| Clock Drawing Test | |
| Mini-Cog | |
| Six-Item Screener | |
| Short Portable Mental Status Questionnaire | |
| Short Test of Mental Status | |
| MODERATE (5–15 minutes) | |
| Mini-Mental State Examination | |
| Montreal Cognitive Assessment | |
| Rowland Universal Dementia Assessment Scale | |
| Saint Louis University Mental Status Examination | |
| LONG (15–30 minutes). Full scales not included here | |
| Addenbrooke’s Cognitive Examination-III (ACE-III) is available from The University of Sydney—Diagnostic Dementia Tests; as a representative of the ACE-III, the Mini-Addenbrooke’s Cognitive Examination (M-ACE) is included here. |
The Clock Drawing Test
INSTRUCTIONS
General setup: Equipment required includes a blank sheet of paper, a sheet of paper, a second paper with the drawing of a clock, a pen, and a chair/table for ease of drawing.
Patient Instructions (Rouleau et al., 1992):
PART A, Clock Drawing: The following instructions are given:
“I would like you to draw a clock, put in all the numbers, and set the hands for 10 after 11.”
PART B, Clock Copy: Following the drawing, the patients should be instructed to copy, as accurately as possible, a clock from a model. The model should contain all the numbers on the clock, be 3 inches in diameter, and located on the upper part of an 8.5 × 11-inch sheet of paper. The hands on the model should be set for 10 after 11. The patient is then instructed to copy the model on the lower part of the same sheet of paper.
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Instructions can be repeated if necessary.
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Patients may use their nondominant hand for drawing the clock.
Name: __________
Date: __________
DRAW A CLOCK WITH ALL THE NUMBERS AND SET THE HANDS FOR 10 AFTER 11.
Name: __________
Date: __________
COPY THIS CLOCK BELOW.
Mini-Cog
Name: __________
Date: __________
Step 1: Three Word Registration
Look directly at person and say, “Please listen carefully. I am going to say three words that I want you to repeat back to me now and try to remember. The words are [select a list of words from the versions below]. Please say them for me now.” If the person is unable to repeat the words after three attempts, move on to Step 2 (clock drawing).
The following and other word lists have been used in one or more clinical studies. For repeated administrations, use of an alternative word list is recommended.
| Version 1 | Version 2 | Version 3 | Version 4 | Version 5 | Version 6 |
| Banana | Leader | Village | River | Captain | Daughter |
| Sunrise | Season | Kitchen | Nation | Garden | Heaven |
| Chair | Table | Baby | Finger | Picture | Mountain |
Step 2: Clock Drawing
Say: “Next, I want you to draw a clock for me. First, put in all of the numbers where they go.” When that is completed, say: “Now, set the hands to 10 past 11.”
Use preprinted circle (see next page) for this exercise. Repeat instructions as needed, as this is not a memory test. Move to Step 3 if the clock is not complete within 3 minutes.
Step 3: Three Word Recall
Ask the person to recall the three words you stated in Step 1. Say: “What were the three words I asked you to remember?” Record the word list version number and the person’s answers below.
Word List Version: __________
Person’s Answers: __________
TOTAL SCORE __________
| Word Recall: (0–3 points) | 1 point for each word spontaneously recalled without cueing. |
| Clock Draw: (0 or 2 points) | Normal clock = 2 points. A normal clock has all numbers placed in the correct sequence and approximately correct position (e.g., 12, 3, 6, and 9 are in anchor positions) with no missing or duplicate numbers. Hands are pointing to the 11 and 2 (11:10). Hand length is not scored. Inability or refusal to draw a clock (abnormal) = 0 points. |
| Total Score: (0–5 points) | Total score = Word Recall score + Clock Draw score. A cut point of <3 on the Mini-Cog has been validated for dementia screening, but many individuals with clinically meaningful cognitive impairment will score higher. When greater sensitivity is desired, a cut point of <4 is recommended as it may indicate a need for further evaluation of cognitive status. |
Clock Drawing for Mini-Cog
Name: __________
Date: __________
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