1. Verbal Fluency: (Name as many animals in
60 seconds as possible)
Animals per 60 seconds
Check if Correct:
a. Point to the ceiling.
b. Point to your nose and window.
c. Point to your foot, door, and ceiling.
d. Point to window, leg, door, and thumb.
3. NAMING AND WORD FINDING: Parts of Objects
Sole of shoe
Buckle of Belt
d. Day of Week
5. NEW LEARNING ABILITY (four unrelated words). State
the first column of words, patient repeats them, 5 minutes later they get 2 points for each
word and then 10 minutes later the get another 2 points for each one recalled. Use the other
column if someone else gave them the test earlier.
After 5 Minutes
After 10 Minutes
a. Brown (Fun) (Grape)
b. Honesty (Loyalty) (Happiness)
c. Tulip (Carrot) (Stocking)
d. Eyedropper (Ankle) (Toothbrush)
6. VERBAL STORY FOR IMMEDIATE RECALL
It was July / and the Rogers / had packed up
/ their four children / in the station wagon / and were off / on vacation.
They were taking / their yearly trip / to the beach / at Gulf Shores.
This year / they were making / a special / one-day stop / at The Aquarium / in New
After a long day's drive / they arrived / at the motel / only to discover / that in their
excitement / they had left / the twins / and their suitcases / in the front yard.
Number of Correct Memories (1 point for each
section up to 13):
7. VISUAL MEMORY (HIDE FIVE OBJECTS and Then
the Patient tells you what is where)
8. PAIRED ASSOCIATE LEARNING (Read Column
#1, Read the first word in Column #2, patient must tell you the second word.)
9. CONSTRUCTIONAL ABILITY (Show the patient
the picture and let them copy it as they look at it for 3 points if a good representation.
3 points each for constructing the flower in a pot and a house in perspective.
Daisy in flower pot
House in Perspective
10. WRITTEN COMPLEX CALCULATIONS (Have pt do
the calculations on paper)