Short Test of Mental Status (STMS)

Short Test of Mental Status (STMS)
Kokmen‚ et al‚ 1987
 
1.    Orientation (8)
Name‚ address‚ current location (building)‚ city‚ state‚ date (day)‚ month‚ year
2.    Attention (7)
Digit span (present 1/sec; record longest correct span) 2-9-6-8-3‚ 5-7-1-9-4-6‚ 2-1-5-9-3-6-2
3.    Immediate recall (4)
Four unrelated words: "apple‚" "Mr. Johnson‚" "ch‎arity‚" "tunnel." Number of trials needed to learn all four:
4.    Calculation (4)
5 x 13; 65 - 7; 58/2; 29 + 11
5.    Abstraction (3)
Similarities: orange/banana‚ dog/horse‚ table/bookcase
6.    Construction (2)
Draw clock face showing 11:15
Copy a cube (diagram of cube shown to patient) (2)
7.    Copy (2)
8.    Information (4)
President; first President; define an island; number of weeks per year
9.    Recall (4)
The four words: "apple‚" "Mr. Johnson‚" "ch‎arity‚" "tunnel" 
Instructions for Administration and Scoring of the Short Test of Mental Status (STMS)
 
Orientation
Each correct response is worth 1 point. The maximum score is 8.
Attention
Usually a span of five digits is given to the patient. If the patient responds correctly‚ the span is increased to six and then to seven. The patient's best performance is then recorded. If the patient is able to repeat seven digits forward‚ the test is terminated. The number of digits correctly repeated is the score; the maximal score is 7‚ and the minimal score is 0.
Immediate Recall
If the patient learns the words on the first trial‚ then the next subtest is given. If the patient is unable to learn all four words‚ the investigator repeats them for a maximum of 4 trials and records the number of trials that the patient requires to learn all 4 words. If the patient is unable to learn all four words by the end of the fourth trial‚ the patient's best performance is recorded (the number of words learned and the number of trials required). Learning is scored in two parts. A point is earned for each word learned (a maximum of 4 points). One less than the number of trials (a maximum of 4) required to learn the words was subtracted from the score. Thus‚ the values that were subtracted were between 0 and 3.
Calculation
Each correct answer earns 1 point‚ and the maximal score is 4.
Abstraction
One point for each word pair is given only for definitely abstract interpretations (for example‚ horse/dog = animal). Concrete interpretations or inability to see a similarity earns 0 points for that word pair. The maximal score is 3.
Construction and Copying
The patient is able to view the diagram of a cube while drawing his or her own version. For each construction‚ an adequate conceptual drawing is scored as 2‚ a less than complete drawing earns a score of 1‚ and inability to perform the task earns a score of 0. The maximum score for the construction tasks is 4.
Information
Each correct answer earns 1 point‚ and the maximal score is 4.
Recall
At the end of the test‚ the patient is asked to recall the four words from the immediate recall subtest. No cues or reminders are provided. The patient earns 1 point for each word recalled‚ and the maximal score is 4.
Total Score
Total score = sum of subtest scores minus (number of trials for acquisition minus 1). For example‚ if a patient learned all four words on the first trial‚ nothing was subtracted from the sum of the subtest scores. If a patient required four trials to learn some or all four words‚ then 3 was subtracted from the sum of the subtest scores.
 
 

Kokmen‚ E.‚ Naessens‚ J.M.‚ Offord‚ K.P. (1978). A short test of mental status: description and preliminary results. Mayo Clinic Proc‚ 62:281-8.

Kokmen‚ E.‚ Smith‚ G.E.‚ Petersen‚ R.C.‚ Tangalos‚ E.G.‚ Ivnik‚ R.J. (1991). The Short Test of Mental Status: correlations with standardized psychometric testing. Arch Neurol‚ 48:725-728.

Tang-Wai‚ D.F.‚ Knopman‚ D.S.‚ Geda‚ Y.E‚ et al. (2003). Comparison of the short test of mental status and the mini-mental state examination in mild cognitive impairment. Arch Neurol‚ 60(12):1777-1781.