Attention and Calculation Flashcards

A patient is asked to count backward from 100 by 7s. After '93', they say '87'. How many errors have they made?

Answer: One error (correct answer was 86)

100 minus 7 is 93, and 93 minus 7 is 86, so saying 87 constitutes one serial subtraction error.

Which alternative task is commonly substituted for serial 7s when a patient has limited education?

Answer: Spell 'WORLD' backward

Spelling 'WORLD' backward is the standard MMSE alternative to serial 7s for individuals with limited formal education.

On the MMSE, how many points are allocated to the Attention and Calculation section?

Answer: 5

The Attention and Calculation section of the MMSE is worth a maximum of 5 points.

A patient correctly completes three of the five serial 7 subtractions. What score do they receive for this section?

Answer: 3 out of 5

Each correctly executed serial subtraction step earns 1 point, so three correct steps yield a score of 3.

Why is the serial 7s task considered a measure of attention rather than pure arithmetic ability?

Answer: It requires sustained concentration and working memory while calculating

Serial 7s demands holding a running total in working memory while performing repeated subtraction, making sustained attention essential.

If a patient makes an error at step 2 of serial 7s (e.g., says 84 instead of 86) but then correctly subtracts 7 from their wrong answer to get 77, how is step 3 scored?

Answer: Correct, because the subtraction of 7 was performed accurately

The MMSE scores each serial 7 step based on whether the patient correctly subtracted 7 from their previous answer, not whether the running total is accurate.

Which cognitive domain is being assessed when the examiner asks a patient to spell 'WORLD' backward?

Answer: Attention and working memory

Spelling 'WORLD' backward assesses attention and working memory, the same domain targeted by serial 7s.