Home Kickstart Assess Evaluate Refer
Brief cognitive screening tests, including those listed below, are used to determine whether an individual should receive a full diagnostic evaluation. There are multiple validated cognitive assessments beyond those listed here. Each assessment has its own benefits and limitations and may not be the best fit for all individuals or populations. For example, assessments that are designed for people living with sensory impairment (e.g., the MoCA for low vision or blindness) may be most appropriate for distinct populations.
Factors to consider when selecting a cognitive screening instrument are:
Each screening instrument has a scoring system that should be used to evaluate individual performance and determine whether cognitive impairment is present. The presence of cognitive impairment is an indicator that further evaluation is necessary. Furthermore, depending on the clinical situation, additional evaluation may be warranted even if the overall score does not indicate cognitive impairment.
The Mini-Cog is a free, validated assessment that is often used by primary care teams. The test includes a 3-word recall and clock-drawing test and is available in multiple languages.
Among its advantages are:
There are 5 total points that can be earned; a score of 0 to 2 indicates cognitive impairment. Detailed instructions are available for scoring the Mini-Cog.
The clock-drawing test can be administered as part of or separate from the Mini-Cog. It can be useful to assess executive function and as a quick screening to determine whether more detailed assessment is needed. People should be able to draw the clock with the numbers in roughly the correct location and with the hands of the clock pointed in the correct direction. Individuals must have had cultural exposure to analog clocks for this assessment to be appropriate. In addition, nonliterate individuals and those with fewer than 5 years of education may make more errors with the clock drawing test (Adhikari, 2021).
The Montreal Cognitive Assessment (MoCA) and the Saint Louis University Mental Status (SLUMS) exam are other popular instruments.
These assessments:
The SLUMS is available in multiple languages, and the MoCA also has multiple language options, an option for use with individuals with visual impairments, and a variety of other resources.
Racial and ethnic differences have been found to influence scoring for the MoCA, and measurement bias may inflate rates of cognitive impairment among historically underserved and marginalized populations (Ratcliffe, 2023).
The Short Test of Mental Status (STMS) is an 8-item questionnaire that assesses for memory and executive function.
This assessment:
In June 2024, they reported that it improved dementia diagnosis and care, based on a clinical trial funded by the National Institutes of Health (NIH) and conducted in an urban primary care setting. The clinical trial confirmed that the 5-Cog is a non-literacy biased, culturally fair cognitive detection tool.
Learn more about the 5-Cog from Dr. Joe Verghese, principle investigator of the study, in the GSA Momentum Discussion Podcast episode, The 5-Cog Paradigm: An Innovation to Improve Detection and Management of Impaired Cognition in Primary Care.
Albert Einstein College of Medicine makes the 5-Cog available free of cost to all researchers for academic pursuits under a simple letter agreement. Commercial entities wishing to incorporate the tool into a product or program are subject to fees and a copyright licensing agreement. For more information, please contact biotech@einsteinmed.edu with the subject headline ‘Enquiry to access the 5-Cog Battery for Detection of Cognitive Impairment test'.
Strategies to Assess for Cognitive Impairment | Brief Cognitive Tests | Structured Assessment Instruments | Case Study | Assess References