The Mini-Cog is a 3-minute screen for cognitive impairment in older adults. It combines a three-word memory check with a clock-drawing task.
Doctors use it to flag possible memory and thinking problems that need closer testing. According to the Mini-Cog instructions from Mini-Test.com, staff can learn it with brief training and use it across diverse older-adult backgrounds. Families who know the steps can understand the result and the next visit.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- What happens during the test?
- How does scoring work?
- How accurate is it?
- Why do clinics use it, and what comes next?
What happens during the test?
The Mini-Test.com directions describe a short spoken sequence. No special equipment is needed, and no clock can be visible during the task.
The order matters. The clock task fills the pause between hearing the words and trying to recall them.
- Hear three unrelated words, such as Banana, Sunrise, and Chair, and repeat them, with up to three tries.
- Draw a clock face, add the numbers, and set the hands to a stated time such as 11:10.
- Recall the three words after finishing the clock.
How does scoring work?
Each recalled word earns one point, for a word score of zero to three. The clock counts as normal only when numbers and hands are approximately correct.
A word score of zero is a positive screen for impairment. A score of one or two with an abnormal clock is also positive, while one or two with a normal clock or a score of three is negative.
How accurate is it?
The March 2024 PLOS One review pooled studies through January 2023. Reported in the March 2024 PLOS One meta-analysis, Mini-Cog found dementia with 76 percent sensitivity and 83 percent specificity across six studies with 4,772 people.
The same review found about 84 percent sensitivity and 79 percent specificity for mild cognitive impairment. For any impairment in primary care, accuracy was about 73 percent sensitivity and 84 percent specificity, so screening alone still misses roughly one-quarter of dementia cases.
Why do clinics use it, and what comes next?
Clinics often choose it because it is free, takes three minutes or less, and fits an ordinary primary-care or Medicare Annual Wellness Visit. Dementia In Home notes this contrast with the longer, about 10-minute copyrighted MMSE and MoCA, with a clinician deciding next steps after the result.
A positive screen does not diagnose dementia. Described in Hartford Institute guidance, a score of zero to two calls for fuller evaluation or specialist referral. Bring a list of medicines, recent examples of daily problems, and questions about referral to that follow-up.
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