Mini-Cog
Brief Cognitive Screen (Geriatric)
<3 → possible impairment; proceed to MoCA or full dementia workup.
Clinicians lean on this acronym when a Medicare wellness visit needs a cognitive screen and the schedule allows three minutes, not thirty. Mini-Cog scores 3-word recall (0, 1, or 2 of 3) plus a clock draw (0 abnormal, 2 normal). Total runs 0-5; under 3 flags possible impairment and prompts a fuller assessment with MoCA, MMSE, or full dementia workup. The AANP exam treats Mini-Cog as the screen, not the diagnosis, and rewards candidates who escalate appropriately rather than stopping at the score. Watch for distractor answers that anchor on the clock alone — both components carry weight, and word recall is the more sensitive piece.
- 13-word registrationSay three unrelated words (e.g., banana, sunrise, chair). Patient repeats to confirm encoding.
- 2Clock-draw testDraw a clock face, put in all the numbers, and set the hands to ten past eleven. 2 points if normal (all numbers correct + hands at 11:10); 0 points if abnormal.
- 33-word recallAsk patient to recall the three words without prompting. 1 point per word (0-3).
Clinical Context
Scores 0-5 (3 recall + 2 clock). <3 flags possible cognitive impairment and warrants MoCA (scores 0-30, <26 abnormal) or MMSE for more detail. Takes ~3 minutes and fits any primary-care visit — designed for the 15-minute slot where MoCA doesn't fit.
Medicare Annual Wellness Visit requires cognitive screening; Mini-Cog or the GPCOG are acceptable. A failed Mini-Cog is not a dementia diagnosis — it triggers further workup: rule out reversible causes (B12, TSH, depression, medications — especially anticholinergics), get imaging if focal findings or rapid progression, and then formal neuropsych testing.
AANP geriatric stem: 78-year-old with "forgetfulness" for a year, normal labs, Mini-Cog 2/5 — next step is MoCA + depression screen + medication review, not starting donepezil empirically.
Related Mnemonics
- ABCD² — TIA Stroke Risk (ABCD² Score)
- AEIOU-TIPS — Causes of Altered Mental Status
- BE FAST — Stroke Recognition (Extended)
- CAM — Delirium Diagnosis (Confusion Assessment Method)
- FAST — Stroke Recognition
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