| ORIENTATION (max. score 10) | |
| What is the year, month, day, date and season? | /5 |
| Where are we now? Street no, road, suburb, city, state. | /5 |
| REGISTRATION (max. score 3) | |
| Ask patient to remember 3 items that you name. | /3 |
| Name 3 objects (e.g. orange, camel, table). | |
| Repeat 5 times or until all learned and ask to recall them after each time. | |
| Only score on first attempt (one mark each). | |
| ATTENTION AND CALCULATION (max. score 5) | |
| Ask pt. to count backwards by several 7s from 100. | /5 |
| (Stop after 5 times) OR spell ‘WORLD’ backwards. | |
| RECALL (max. score 3) | |
| Ask pt. to recall the 3 objects above. 1pt/word recalled. | /3 |
| LANGUAGE (max. score 3) | |
| Show two objects (point to watch then pen). What's this? | /2 |
| Ask to repeat ‘NO IFS, ANDS or BUTS’ | /1 |
| THREE STAGE COMMAND (max. score 3) | |
| Give pt. a blank sheet of paper and say ‘take this paper in your right hand, fold it in half, and put it on the floor’. | /3 |
| READING (max. score 1) | |
| On a blank piece of paper write ‘CLOSE YOUR EYES’. | /1 |
| Ask pt. to read it and do what it says. Score 1 if obeys. | |
| WRITING (max. score 1) | |
| Ask pt. to write a complete sentence. Score 1 point if it has a noun and a verb. | /1 |
| COPYING (max. score = 1) | |
| Draw intersecting pentagons and ask pt. to copy the drawing. 1 point if all 10 angles present and the two figures intersect. | /1 |
 ‘Copy this design’ | /30 |
| GUIDE: 18–24 (probable mild dementia); 10–17 (probable moderate impairment); <10 (severe impairment). | |