Prior to carrying out the test please make sure that the patient is aware that this test will assess their memory. Tell them that some of the questions may seem abnormal or out of the ordinary and they should only answer the questions as best they can.
1. Knows age
Yes
No
2. Knows their date of birth
Yes
No
3. Knows time to the nearest hour
Yes
No
4. Knows year
Yes
No
5. Give the patient an address to Remember. Recall this address at the end of the test (see below).
e.g. 35 North Street
6. Knows their current location
(name of hospital, care home, clinic or house number)
Yes
No
7. Recognizes two people
(e.g. a docotor or a nurse or porter or maid etc - recognize jobs or recognize a family member son, daughter, husband)
Yes
No
8. Remembers date/year of major event
(e.g. end/beginning of world war 2 or independence day where appropriate)
Yes
No
9. Can name current leader / monarch
(e.g. president, prime minister or queen name)
Yes
No
10. Can count backwards from 20 to 1.
(Only click yes if they can do count all the way from 20 to 1)
Yes
No
5. Recall/Registration exercise: Can recall the address given earlier in the test.
Yes
No
If the score is
6 or less
the patient is likely to have delirium or dementia. Consider a minimental state examination.
1 point for each "Yes" and 0 points for a "No" will be awarded. The maximum possible score is 10.