Blessed Scale Exam

SHORT BLESSED SCALE EXAM

The Short Blessed Scale is to be completed at any point during the interview if the respondent appears to be cognitively impaired.

ERROR SCORES

SB-1. What year is it now? ______________________

4 FOR ANY ERROR 0 4

SB-2. What month is it now? ____________________

3 FOR ANY ERROR 0 3

I am going to name three objects. After I say them, please repeat them: “Apple, Table, Penny.”

NO SCORE – SCORE FOR ITEM SB-6

SB-3. About what time is it? ____________________

3 FOR ANY ERROR 0 3

SB-4. Please count backwards from 20 to 1.

[20, 19, 18, 17, 16, 15, 14, 13, 12, 11, 10, 9, 8, 7, 6, 5 , 4, 3, 2, 1]

2 PER ERROR 0 2 4

SB-5. Now I am going to spell a word forwards and I want you to spell it backwards. The word is WORLD, W-O-R-L-D. Please spell WORLD backwards. (REPEAT SPELLING IF NECESSARY)

2 PER ERROR 0 2 4 6 8 10

SB-6. Please repeat the three objects I asked you to repeat before.

[APPLE / TABLE / PENNY]

2 PER ERROR 0 2 4 6

TOTAL NUMBER OF ERRORS IN SB-1 TO SB-6: _________

IF THE TOTAL NUMBER OF ERRORS IS GREATER THAN 11, TERMINATE THE INTERVIEW. BE SURE TO PAY THE RESPONDENT.