Cognitive Impairment Screening with 6 Questions

 

		Patient can identify current year (1 point)
		Patient can identify current month (1 point)
		Patient can identify current day (1 point)
		Patient can recall "apple" after 5 mins. (1 point)
		Patient can recall "table" after 5 mins. (1 point)
		Patient can recall "penny" after 5 mins. (1 point)

 

Total Criteria Point Count:
 

 

Questions

 

0 to 3 points:	Impairment Likely
4 to 6 points:	Impairment less likely

 

Notes

• This 6 item screen for cognitive impairment requires a typical 3 item recall test.
• The subject should be able to repeat the three items initially, then recall them after 5 minutes.

 

References

1. Callahan CM, Unverzagt FW, Hui SL, et al. Six-item screener to identify cognitive impairment among potential subjects for clinical research. Med Care. 2002 Sep;40(9):771-81. PubMed ID: 12218768