Short Portable Mental Status Questionnaire (SPMSQ)
Use the Short Portable Mental Status Questionnaire (SMPSQ) to quickly gauge the cognitive functioning of elderly patients.
What is cognitive impairment in older adults/elderly?
As we age, our bodies change. We experience physical weakness and fragility, making us susceptible to illnesses that can hinder our functioning. Our brains also suffer. As we grow older, our cognitive abilities can decline, initially manifesting as minor impediments but potentially leading to more severe impairments.
- Becoming more forgetful by the day (e.g., we take longer to remember a person’s name, we forget to do something important or simple chores, we forget how to do certain things, we forget plans),
- We start to lose our train of thought, especially during conversations,
- We stop understanding whatever it is we’re reading, watching, or playing and need to refresh a bit,
- We get lost or feel lost in places supposedly familiar to us,
- We become moody and impulsive,
- At worst, we forget ourselves, and we become unresponsive to most things.
Several things could cause cognitive impairment or decline, like depression, delirium, medication, and neurological problems such as Alzheimer’s Disease and dementia.
People will experience cognitive decline or impairment differently. Some will have mild or moderate decline/impairment, and their symptoms can be managed enough to the point that it’s possible for them to have functional independence or have minimal assistance from others. Some have severe cognitive decline/impairment, and these people require the most assistance with almost everything.
Printable Short Portable Mental Status Questionnaire (SPMSQ)
Download this Short Portable Mental Status Questionnaire (SPMSQ) to assess cognitive function of elderly patients.
How to use the Short Portable Mental Status Questionnaire (SPMSQ)
In order to assess a person for cognitive decline/impairment, you can use certain assessments. One such assessment is the Short Portable Mental Status Questionnaire (SPMSQ), developed by Eric Pfeiffer, MD.
The Short Portable Mental Status Questionnaire is meant to be administered as an interview. The person using the assessment will ask the interviewee ten questions without prompting or cues:
- What is the date today? - The interviewee must answer with the correct day, month, and year. If they only specify the day and month, ask them what year it is.
- What day of the week is it today? - The interviewee must answer with the correct day of the week.
- What is the name of this place? - This can be conducted anywhere, hence the portable in the name. The interviewee must answer with the correct name. If this is conducted at home, “Home” is a sufficient answer. Other answers can be the name of the city, mall, institution, etc.
- What is your telephone number? - The interviewee must answer with their telephone number or cellphone number. The interviewer must be able to verify this. If the interviewee doesn’t have a telephone or cellphone, ask them what their street address is, and make sure to verify it.
- How old are you? - The interviewee must specify their age correctly.
- When were you born? - The interviewee must specify their date of birth correctly.
- Who is the current president? - The interviewee must specify the name (the surname is fine) of the country they’re living in.
- Who was the president before them? - The interviewee must specify the name (surname is also fine) of the previous president of the country they’re living in.
- What is/was your mother’s maiden name? - The interviewee must specify the maiden name of their mother correctly.
- Can you count backward from 20 by 3’s? - The interviewee must count backward from 20 by subtracting. The correct answer is 17, 14, 11, 8, 5, and 2, in that order.
You need to write down their responses for each item as well as note down how many errors they’ve made for each one.
Before tallying the errors, ask the interviewee what their highest educational attainment was.
If they only have a grade school education or below, you can subtract one error from their total errors. If they’ve had a total of 5 errors, you can just count 4.
If they have gone past high school and had at least a year of college education, you can add one error to their total errors. For example, if they had a total of 5 errors, you can add one and count it as 6.
To interpret the scores, just refer to the following ranges and designations:
- 0-2 errors: normal mental functioning
- 3-4 errors: mild cognitive impairment
- 5-7 errors: moderate cognitive impairment
- 8 or more errors: severe cognitive impairment
Do note that the SPMSQ is merely used to gauge the potential level of cognitive impairment or decline a person has. It is not a diagnostic tool. It’s best to have the interviewee undergo a comprehensive exam to confirm the cognitive impairment/decline and if any underlying conditions are causing it.
Short Portable Mental Status Questionnaire (SPMSQ) Example
Now that you understand cognitive decline/impairment and the Short Portable Mental Status Questionnaire (SPMSQ), let's look at the questionnaire itself.
Our template is an enhanced version of the original, featuring editable fields for those who prefer digital formats. We've also included an Additional Comments Box for interviewers to note any observations they make during the interview. Who knows? You might notice something noteworthy that could indicate cognitive impairment/decline beyond the questionnaire responses. Your insights could assist professionals in determining the next steps.
If you like what you see and believe this is a good way to gauge the person you’re taking care of or the patients you’re handling, then feel free to download our free Short Portable Mental Status Questionnaire PDF template!
Download this Short Portable Mental Status Questionnaire (SPMSQ) Example:

When is it best to use the Short Portable Mental Status Questionnaire (SPMSQ)?
If you’re wondering when it’s best to use this nifty assessment, that depends on what you are.
Are you a healthcare professional specializing in cognitive and neurological issues, a therapist, or a similar practitioner? If so, one of the best times to use this is when a patient presents themselves to you or is brought by a loved one or companion to have the patient checked for potential cognitive decline/impairment.
Using this assessment as one of the initial evaluations in a comprehensive examination is advisable. The results can provide a foundation for determining which additional tests are necessary. If the results indicate mild cognitive decline or impairment, it would be beneficial to administer similar questionnaires to ensure consistency. However, if the results indicate moderate or severe cognitive decline or impairment, the next step should be conducting tests to identify the reasons behind the decline.
This assessment is not limited to professionals. You can still utilize this assessment if you're a caregiver or someone without professional training. If you observe signs of cognitive decline or impairment in the person you're caring for or a loved one, you can refer to this assessment and have them complete it. If the results indicate mild to severe cognitive decline or impairment, scheduling a checkup with a specialist for further evaluation is important.
What are the benefits of using the Short Portable Mental Status Questionnaire (SPMSQ)?
It can be used anytime, anywhere!
The Short Portable Mental Status Questionnaire (SPMSQ) offers incredible convenience as it can be utilized at any time and in any location. Its purpose is to assist individuals in recognizing signs of cognitive decline or impairment in those they are with or care for. Our PDF version further enhances its usefulness by allowing it to be completed on a mobile device.
It can help professionals determine what to do next for the patient.
The Short Portable Mental Status Questionnaire (SPMSQ) is a cognitive decline/impairment screening tool. It’s not a diagnostic tool. The primary function of this assessment is to simply gauge a person for the possibility of cognitive decline/impairment.
The score ranges and designations merely suggest the possibility that a person might have no cognitive decline or if it’s mild, moderate, or severe. It doesn’t necessarily confirm it, but the results are reliable because they can help professionals determine what to do next, like issuing similar assessments to check for consistencies or inconsistencies. If the scores point to the possibility of moderate or severe decline, they can try to get to the bottom of things by checking for possible neurological conditions that a person might have.
It can be used to monitor persons with cognitive decline/impairment
The Short Portable Mental Status Questionnaire (SPMSQ) is not limited to one-time use. It can be employed even after confirming a person's cognitive decline/impairment and other related issues. As a monitoring tool, it effectively tracks the progression of cognitive decline/impairment. If the decline is not severe and manageable, the assessment can determine if the patient's cognitive functioning improves.
How can Carepatron help with neurological work?
If you happen to be a neurologist or a similar healthcare professional, we hope this guide served as a good introduction or refresher to the Short Portable Mental Status Questionnaire (SPMSQ), and we hope the template tied to it helps you with your work.
Now, while we have you here, we’d like to ask you to spend a bit of your time exploring more of the Carepatron platform if you haven’t. We have numerous features that we believe will help you improve your work by streamlining your workflows and the quality of your work. We won’t get into all these features here, but we’d like to highlight one of them for you: our resource library.
Our resource library is one of the features we’re most proud of. It houses a massive collection of clinical resources that cover numerous healthcare fields and topics, including neurology, physical therapy, and mental health. This guide and the template tied to it are a part of it. If you’re looking for similar assessments, we have different kinds like the Clock Drawing Test, the Short Blessed Test, Cognitive Decline and Memory Loss Assessment, the SLUMS Test, and the FAST Scale. These assessments will help you narrow down cognition-related problems. What’s great is that they’re all free, so download as much as you want and need!

Commonly asked questions
It depends on the person you’re administering the assessment to. If they don’t have any cognitive impairments, they will likely accomplish this test within five minutes. If they do have signs of cognitive decline/impairment, it might take longer than that.
No, but that will depend on the patient. If they do have cognitive decline/impairment, they might experience some difficulty answering the questions, especially if the decline has impacted their memory or quickness of thinking. The only one that actually poses a bit of a challenge is the last question, which requires the patient to count backward in 3’s. Not everyone’s good with numbers.
Yes. It’s called portable for a reason. You can use this anytime, anywhere. You can be a caregiver, a loved one, a friend, or even a companion. If you have a copy of this at the ready, you can definitely use this.


