What Is the Mini-Cog Test?

The Mini-Cog test is a three-minute dementia screening tool that combines two tasks: recalling three words and drawing a clock face. It is scored out of 5 points, and a total of 0 to 2 indicates a higher likelihood of clinically important cognitive impairment. The instrument was developed by Soo Borson and colleagues and published in 2000. Like every brief cognitive screen, it flags people who need a closer look; it does not diagnose dementia, and it is a screening tool, not an IQ test.

The examiner reads three unrelated words (the standardized instrument provides six validated lists, such as banana, sunrise, chair) and asks the patient to repeat them. Next comes the clock: draw a clock face, put in all the numbers, and "set the hands to 10 past 11." The clock serves two purposes at once. It is a genuine test of planning, visuospatial ability, and executive function, and it works as a "distractor," occupying attention so the final step, recalling the three words, measures real retention rather than rehearsal. The official instructions note that examiners may repeat the clock instructions as needed, because that step is not a memory test, and should move on if the clock is not complete within three minutes.

• Word recall (0-3 points): One point for each word recalled without prompting.

• Clock drawing (0 or 2 points): Two points for a normal clock, zero for an abnormal one. A normal clock has all twelve numbers in sequence and roughly correct position, with no missing or duplicated numbers, and hands pointing to the 11 and the 2.

• Total (0-5): A score of 0, 1, or 2 indicates a higher likelihood of clinically important cognitive impairment. A score of 3, 4, or 5 indicates a lower likelihood of dementia, though it does not rule out some degree of impairment.

The official guidance adds a useful nuance: the cut point of below 3 has been validated for dementia screening, but many people with clinically meaningful impairment score higher. When greater sensitivity is desired, clinicians use a cut point of below 4 as the trigger for further evaluation.