Mini-Cog

Primer

The Mini-Cog is a very brief, 3 minute assessment used to screen for dementia. It can be widely used in patients with various language backgrounds and education levels. It is comparable to the MMSE, and in fact has fewer false positives.

Download MiniCog

Instructions
MiniCog

Indications

The Mini-Cog helps is a screening test to detect cognitive impairment in older adults, and can be used in both healthcare and community settings.

Components and Scoring

Registration

Ask the patient to listen carefully to 3 unrelated words, and have them repeat 3 the unrelated words and commit them to memory.

Clock Drawing

See main article: Clock-Drawing Test (CDT)

The clock drawing is considered normal if the numbers on the clock are in correct sequence, and the hands readably display the requested time.

Recall

The patient is requested to recall the 3 words from memory.

Interpretation

The Mini-Cog can be interpreted in a step-wise fashion (see Table as well):

  • If 0 of out 3 words are recalled, it is a positive screen for dementia, regardless of the clock-drawing
  • If all 3 words are recalled, it is immediately a negative screen for dementia, regardless of the clock-drawing
  • If the patient recalls 1-2 words, then the clinician needs to further refer to the clock-drawing:
    • If there is 1-2 words (of out 3) for recall, with a normal clock, it is a negative screen for dementia
    • If there is 1-2 words (of out 3) for recall, with an abnormal clock, it is a positive screen for dementia

Mini-Cog Interpretation

3/3 words recalled 2/3 words recalled 1/3 words recalled 0/3 words recalled
Normal clock Negative screen Negative screen Negative screen Positive screen
Abnormal clock Negative screen Positive screen Positive screen Positive screen

Limitations

The clock drawing may be difficult for individuals who do not have a regular exposure to analog clocks, lack of experience in drawing or writing, and in those with low education.