The Mini-Cog Cognitive Assessment Test is a brief, simple, and reliable tool used to screen for possible cognitive impairment in adults. It combines a short memory test with a clock drawing task, allowing clinicians to quickly assess recall, executive functioning, and visuospatial abilities. The tool is frequently used in primary care, geriatrics, and mental health settings where early identification of cognitive concerns is important.
This resource page summarizes how the Mini-Cog works, what the test involves, and how clinicians can use it to support decisions about further evaluation. The assessment includes three-word registration, a clock drawing exercise, and a delayed recall task that together offer a practical overview of cognitive functioning. A downloadable version of the Mini-Cog Cognitive Assessment Test is available for clinicians using the download resource button above.
Understanding How the Mini-Cog Works
The Mini-Cog consists of three parts: three-word registration, a clock drawing task, and three-word recall. In the registration step, the clinician speaks three unrelated words and asks the patient to repeat them to confirm understanding. The PDF shows six different word lists that may be used in rotation, with options such as banana, sunrise, chair or leader, season, table (page 1). This step establishes the words that the patient will be asked to recall later.
The second part is the clock drawing exercise, where the clinician instructs the patient to draw a clock face, place numbers in their correct positions, and set the hands to ten past eleven. The instructions emphasize that this is not a memory test and that prompts may be repeated as needed (page 1 and pages 3–4). A normal clock must include all numbers once, positioned correctly, and must display two hands pointing to the appropriate times.
Finally, the patient is asked to recall the three original words. The Mini-Cog scoring system assigns up to three points for recall and up to two points for the quality of the clock drawing. A total score of zero to five is possible, with lower scores indicating greater likelihood of cognitive impairment. According to the scoring instructions on page 4, a score below three is often used as an indicator that further cognitive evaluation may be appropriate, with some settings using a cutoff of four when higher sensitivity is desired.
“Brief cognitive screening tools allow clinicians to quickly identify individuals who may require further assessment for memory or thinking changes.”
— National Institute of Mental Health
The Mini-Cog is designed to be easy to administer, taking only a few minutes and requiring no special equipment. Its combination of memory and executive-function testing makes it especially useful for detecting early cognitive changes.
Frequently Asked Questions
Early signs may include forgetfulness, difficulty finding words, trouble managing daily tasks, reduced problem-solving ability, or increased reliance on reminders. These symptoms may develop gradually and can sometimes be mistaken for normal aging. Recognizing changes early helps clinicians guide further assessment.
Cognitive impairment can lead to difficulty managing medications, finances, appointments, or household responsibilities. Individuals may experience challenges with judgment, planning, or navigating familiar environments. Understanding functional changes supports appropriate care planning.
Age, family history, vascular conditions, chronic medical illness, head injury, and lifestyle factors may influence risk. Mental health conditions such as depression can also contribute to cognitive symptoms. Identifying risk factors helps clinicians decide when screening may be useful.
Normal aging may involve mild changes in memory or processing speed, but daily functioning remains intact. Cognitive impairment affects the ability to perform routine tasks and may involve more noticeable memory gaps or confusion. Clinical assessment helps determine the underlying cause.
Treatment may include managing medical conditions, engaging in structured cognitive activities, supporting physical activity, and encouraging social engagement. When appropriate, medication classes such as cognitive enhancers may be considered. A comprehensive approach supports both safety and quality of life.
Conclusion
The Mini-Cog Cognitive Assessment Test is a practical and efficient tool that helps clinicians identify potential cognitive impairment during routine encounters. By combining a short memory task with a clock drawing exercise, the Mini-Cog offers insight into recall, attention, executive function, and visuospatial skills in just a few minutes.
Using the Mini-Cog as part of routine screening allows clinicians to recognize early signs of cognitive change and determine whether further evaluation is needed. The downloadable resource provides complete administration and scoring instructions using the download resource button above. The Mini-Cog supports patient centered care by helping clinicians make informed decisions about cognitive health.
The Mini-Cog Cognitive Assessment Test assists clinicians in early identification, structured assessment, and appropriate follow up for concerns related to memory or thinking.