Several Tests of Dementia Severity:

Attachment A: FAQ (1982)

Attachment B: MMS (1975)
Attachment C: Blessed BOMC (6 items) (1983)
Attachment D: Blessed BIMC (29 items) (1968) Br J Psychiatry. Jul;114(512):797-811.
Attachment E: Short Test of Mental Status (1987)
http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat6.section.35131

Attachment A. Functional Activities Questionnaire (FAQ): Administration and Scoring

The FAQ is an informant-based measure of functional abilities. Informants provide
performance ratings of the target person on 10 complex, higher-order activities.
Individual Items of the Functional Activities Questionnaire
1. Writing checks, paying bills, balancing checkbook.
2. Assembling tax records, business affairs, or papers.
3. Shopping alone for clothes, household necessities, or groceries.
4. Playing a game of skill, working on a hobby.
5. Heating water, making a cup of coffee, turning off stove.
6. Preparing a balanced meal.
7. Keeping track of current events.
8. Paying attention to, understanding, discussing TV, book, magazine.
9. Remembering appointments, family occasions, holidays, medications.
10. Traveling out of neighborhood, driving, arranging to take buses.
The levels of performance assigned ranged from dependence to independence, and are
rated as follows:

Dependent = 3
Requires assistance = 2
Has difficulty but does by self = 1
Normal = 0

Two other response options can also be scored:

Never did [the activity], but could do now = 0

Never did and would have difficulty now = 1

A total score for the FAQ is computed by simply summing the scores across the 10 items.
Scores range from 0 to 30. A cutpoint of "9" (dependent in three or more activities) is
recommended.
Source: Pfeffer RI, Kurosaki TT, Harrah CH, et al. Measurement of functional activities of
older adults in the community. J Gerontol 1982;37:323-9. Copyright 1982, Gerontological
Society of America. Used with permission.
Attachment B. Folstein Mini-Mental State Examination
Mini-Mental State ExaminationAttachment B. Mini-Mental State Examination

Maximum
Score

Score