Patient scores one point for identifying the correct: year, season, month, day, and date
Patient scores one point for identifying each of the following: country, province, city, hospital, and floor
Registration (3)
Ability to repeat 3 unrelated words: name 3 unrelated items to the patient (e.g., cup, phone, water). Patient scores one point for each word that they are able to recall on the first attempt.
Attention (5)
Spelling “world” backwards or counting down from 100 by 7s or naming the months of the year backwards
Recall (3)
Repeating the previous 3 unrelated words after a delay
Language (9)
Naming objects (2): point to two common objects (e.g. pen and clock) and ask the patient to identify them
Repetition of simple phrases (1): ask patient to repeat “no ifs, ands, or buts”
3-step commands (3): have patient follow a 3-step command: “Take this piece of paper with your right hand, fold it in half, and give it back to me”
Follow a written command (1): write a simple command on a piece of paper (e.g. touch your nose) and ask the patient to read it and follow the command
Writing full sentences (1): ask the patient to write out a full sentence. Keep the paper for future comparison
Drawing simple objects (1): ask the patient to copy a simple object that you have drawn
References
Bickley, Lynn S. Bates' Guide to Physical Examination and History Taking. 8th ed. Philadelphia, PA: Lippincott Williams & Wilkins: 2003.
Lincoln, Matthew, McSheffrey eds. Essentials of Clinical Examination Handbook. 6th ed. Toronto, ON: University of Toronto Medical Society: 2010.