Mental Status Questionnaire (MSQ)
1. What is the name of this place?
2. Where is it located (address)?
3. What is today’s date?
4. What is the month now?
5. What is the year?
6. How old are you?
7. When were you born (month)?
8. When were you born (year)?
9. Who is the president of the United States?
10.Who was the president before him?
This instrument can be found at: www.a4ebm.org/sites/default/files/Measuring%20Health.pdf
Kahn‚ R.L.‚ Goldfarb‚ A.I.‚ Pollack‚ M.‚ Peck‚A. (1960). Brief objective measures for the determination of mental status in the aged. Am J Psychiatry‚ 117:326–328.
Fillenbaum‚ G.G. (1980). Comparison of two brief tests of organic brain impairment. Journal of the American Geriatrics Society‚ 28(8): 381-384.
Lesher‚ E.L.‚ Whelihan‚ W.M. (1986). Reliability of mental status instruments administered to nursing home residents. J Consult Clin Psychol‚ 54:726–727.
McDowell‚ Ian. (2006). Measuring Health: A Guide to Rating Scales and Questionnaires‚ Third Edition. OXFORD UNIVERSITY PRESS