Mini-Cog: scoring, cutoffs & interpretation

01 - What it measures

What this scale measures.

The Mini-Cog is a brief cognitive screen for older adults combining two tasks: registration and delayed recall of three words, and the clock drawing test. It takes about three minutes and was designed as a "cognitive vital sign" usable in primary care and multilingual populations, with minimal education and language bias compared with longer instruments (Borson et al., 2000, Int J Geriatr Psychiatry).

It is administered by a clinician rather than self-completed, so no interactive version is offered here. Developed by Soo Borson and colleagues (2000).

02 - Scoring & cutoffs

How scoring works.

Scores range 0-5: one point per word recalled (0-3) and 2 points for a normal clock (0 or 2). A total of 0-2 is a positive screen for possible dementia; 3-5 is a negative screen. When higher sensitivity is wanted, some guidance uses a cutoff below 4. A positive screen is not a diagnosis - it indicates the need for fuller cognitive assessment.

03 - Validation evidence

How well it performs.

In the original population-based validation the Mini-Cog had 76% sensitivity and 89% specificity for dementia (Borson et al., 2003, J Am Geriatr Soc). A 2024 systematic review and meta-analysis found pooled sensitivity 76% and specificity 83% for detecting cognitive impairment (PLOS ONE, doi:10.1371/journal.pone.0298686).

04 - How it compares

How it compares to the alternatives.

05 - Licensing, explained

How licensing works.

The Mini-Cog is copyrighted by S. Borson. It is free for use by health professionals, hospitals, clinics and other non-commercial providers without needing permission. Commercial use, modification or use in research requires prior written permission and a licensing agreement (mini-cog.com). That is why no interactive version, word lists or stimulus materials are reproduced here. Official forms and administration instructions are available from mini-cog.com.

References

Source literature.

1. [1]Borson S, Scanlan J, Brush M, Vitaliano P, Dokmak A. The Mini-Cog: a cognitive 'vital signs' measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry. 2000;15(11):1021-1027. (2000)
2. [2]Borson S, Scanlan JM, Chen P, Ganguli M. The Mini-Cog as a screen for dementia: validation in a population-based sample. J Am Geriatr Soc. 2003;51(10):1451-1454. (2003)
3. [3]Mini-Cog(c) official site - forms, instructions and licensing.
4. [4]Diagnostic accuracy of the Mini-Cog for cognitive impairment: a systematic review and meta-analysis. PLOS ONE. 2024. (2024)