Mini-Cog Calculator

inputs

Three-word recall (0–3 words recalled)Ask patient to repeat and remember 3 unrelated words, then recall after clock drawing

Clock drawing test (CDT) — normal
Ask patient to draw a clock face showing a specific time (e.g., 11:10). Normal = all numbers present, roughly correct position, hands showing correct time

✓ when to use

Use as a brief cognitive screen in primary care, geriatric assessment, pre-operative evaluation, and any clinical encounter where cognitive impairment is suspected. Takes 2–4 minutes. Suitable for initial screening — positive results should trigger comprehensive cognitive assessment.

✗ when not to use

Mini-Cog is a screening tool, not diagnostic. A negative screen does not exclude mild cognitive impairment or early dementia. Clock drawing interpretation is clinician-dependent and has moderate inter-rater reliability. Not validated in acute delirium (use CAM for that). Not suitable for patients with significant visual impairment or motor disability affecting drawing.

clinical pearls

Scoring algorithm: 0 words recalled = positive (impaired) regardless of clock. 3 words recalled = negative (normal) regardless of clock. 1–2 words recalled = clock drawing determines outcome (normal clock = negative, abnormal clock = positive).
Clock drawing tests executive function and visuospatial ability in addition to memory. It catches cognitive domains that word recall alone would miss.
The Mini-Cog's key advantage over MMSE is brevity (2–4 min vs 10–15 min) and minimal education/language bias. It is more suitable for busy primary care settings and culturally diverse populations.
A positive Mini-Cog should prompt further assessment, not an immediate dementia diagnosis. Comprehensive tools (ACE-III, MoCA) and specialist memory clinic referral provide the detail needed for diagnosis.
In pre-operative settings, a positive Mini-Cog identifies patients at higher risk of post-operative delirium, longer hospital stay, and functional decline. This should trigger delirium prevention measures.

✓ when to use

✗ when not to use

clinical pearls

Scoring algorithm: 0 words recalled = positive (impaired) regardless of clock. 3 words recalled = negative (normal) regardless of clock. 1–2 words recalled = clock drawing determines outcome (normal clock = negative, abnormal clock = positive).
Clock drawing tests executive function and visuospatial ability in addition to memory. It catches cognitive domains that word recall alone would miss.
The Mini-Cog's key advantage over MMSE is brevity (2–4 min vs 10–15 min) and minimal education/language bias. It is more suitable for busy primary care settings and culturally diverse populations.
A positive Mini-Cog should prompt further assessment, not an immediate dementia diagnosis. Comprehensive tools (ACE-III, MoCA) and specialist memory clinic referral provide the detail needed for diagnosis.
In pre-operative settings, a positive Mini-Cog identifies patients at higher risk of post-operative delirium, longer hospital stay, and functional decline. This should trigger delirium prevention measures.

Mini-Cog

inputs

✓ when to use

✗ when not to use

clinical pearls

related tools