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Appendix C: Dementia Screening

INTRODUCTION

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I am going to ask you some questions to test your memory.

Le voy a preguntar algunas preguntas para examinarle su memoria.

We may repeat these tests at a later date to evaluate any changes as you age.

Puede que le repitamos estos examenes en una fecha mas tarde para evaluarle cualquier tipo de cambios a medida que usted envejece.

Try to relax as you answer the questions.

Trate de relajarse al contester estas peguntas.

Are you ready?

¿Está listo?

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The Short Portable Mental Status Questionnaire (SPMSQ)

Cuestionario Portátil Corto para el Estado Mental

1. What is the date, month, and year?

1. ¿En qué día, mes, y año estamos?

2. What is the day of the week?

2. ¿En qué día de la semana estamos?

3. What is the name of this place?

3. ¿Cuál es el nombre de este lugar donde nos encontramos?

4. What is your phone number?

4. ¿Cuál es su número de teléfono?

5. How old are you?

5. ¿Qué edad tiene usted?

6. When were you born?

6. ¿Cuándo nació usted?

7. Who is the current president?

7. ¿Cuál es el nombre de nuestro presidente actual?

8. Who was the president before him?

8. ¿Cuál es el nombre del presidente antes del actual?

9. What was your mother’s maiden name?

9. ¿Cuál es su apellido materno?

10. Can you count backwards from twenty by threes?

10. ¿Puede usted contar de veinte hacia abajo de tres en tres, por ejemplo veinte, diez y siete, etcétera?

  • For example, start with 20 and subtract 3 each time.

  • Por ejemplo, empiece con veinte y quítele tres sucesivamente.

Scoring:

  • 0–2 errors: normal mental functioning

  • 3–4 errors: mild cognitive impairment

  • 5–7 errors: moderate cognitive impairment

  • 8 or more errors: severe cognitive impairment

*One additional error is allowed in each level of scoring if a patient has had an 8th grade school education or less.

*One less error is allowed at each scoring level if the patient has had education beyond the high school level.

Source:

Pfeiffer, E. (1975). A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. Journal of American Geriatrics Society, 23, 433–441.

THE MINI-COG ASSESSMENT INSTRUMENT FOR DEMENTIA

The Mini-Cog assessment instrument combines an uncued three-item recall test with a clock drawing test (CDT). The Mini-Cog is relatively uninfluenced by level of education or language variations.

Administration:

  1. Instruct the patient to listen carefully to and remember three unrelated words and then to repeat the words.

  2. Instruct the patient to draw the face of a clock, either on a blank sheet of paper or on a sheet ...

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