Strengths and Limitations

As a screen for cognitive impairment: The Mini-Cog™ is a useful screen for clinically important cognitive impairment, not a diagnostic test. As with all screening tests, false positive and false negative results are possible, but for detection of dementia, it offers access in non-specialist settings, brief administration time (<3 minutes), relative freedom from bias due to language and education, and ease of administration through an interpreter.  The Mini-Cog™ is available in multiple languages.  Nevertheless, the clock drawing portion may challenge individuals lacking regular exposure to analog clocks, lack of experience in drawing or writing, and those with very low levels of educational attainment, for whom alternative approaches to detecting cognitive impairment may be required.

 

As a tool for research on the health care impact of cognitive impairment: The Mini-Cog™’s accessibility to non-specialists makes it useful in assessing individuals and/or populations unlikely to seek evaluation by cognitive disorder specialists. Studies of older adults in community and independent living settings find a relationship between low Mini-Cog score and low health literacy, poor knowledge of personal medications, need for everyday assistance, and higher acute care utilization, and a large study of patients hospitalized with heart failure found an association with readmission rates.

 

More information about the strengths and limitations of the Mini-Cog™ can be found on the references page of this website.