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SPMSQ
SPMSQ: Score based on the number of ERRORS. Raw score is automatically adjusted based on education level.
Patient Education Level
Mark Correct or Error for each
1. What is the date today? (Month, Day, Year)
2. What day of the week is it?
3. What is the name of this place?
4. What is your telephone number? (Or street address if no phone)
5. How old are you?
6. When were you born?
7. Who is the President of the US (or current head of state/prime minister)?
8. Who was the President (or head of state) just before him/her?
9. What was your mother's maiden name?
10. Subtract 3 from 20 and keep subtracting 3 from each new number, all the way down.
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Rapid cognitive screening in community-dwelling older adults.
Settings where the MMSE is too time-consuming or physically demanding (e.g., telephone interviews).
Screening populations with lower education levels.
Education Correction
Unlike the raw MMSE, the SPMSQ inherently builds in a scoring correction for the patient's level of education and race, making it a fairer tool for historically marginalized or low-literacy populations.
Section 2
Formula & Logic
Scoring
10 questions assessing orientation, memory, and concentration.
Score is based on the number of ERRORS (0-10).
0-2 errors: Intact intellectual functioning.
3-4 errors: Mild intellectual impairment.
5-7 errors: Moderate intellectual impairment.
8-10 errors: Severe intellectual impairment.
Education Adjustments
Grade School Education
Allow 1 more error (decrease error score by 1).
High School Education
No adjustment.
Beyond High School
Allow 1 less error (increase error score by 1).
Section 3
Pearls/Pitfalls
Simplicity and Applicability
Because it requires no drawing, reading, or writing (unlike the MMSE or MoCA), the SPMSQ can be administered to patients who are visually impaired, bedbound, or paralyzed, as well as over the telephone.
Section 4
Next Steps
Management
Section 5
Evidence Appraisal
Primary Reference
A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients.
Pfeiffer E. • J Am Geriatr Soc.. 1975;23(10):433-41. The original validation paper establishing the education and race corrections.
Section 6
Origins
Eric Pfeiffer
Developed by Eric Pfeiffer in 1975 as a highly portable, completely verbal alternative to existing complex psychometric tests. It was designed specifically to screen for "organic brain syndrome" (dementia) rapidly in the community.
