CHRIS Portal - Cognition (CHRIS baseline) module

Orientation time (year)

What year is this?

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Orientation time (season)

Which season is this?

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Orientation time (month)

What month is this?

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Orientation time (date)

What is today’s date?

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Orientation time (day of the week)

What day of the week is this?

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Orientation place (country)

What country are we in?

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Orientation place (province)

What province are we in?

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Orientation place (town)

What town are we in?

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Orientation place (building)

What is the name of this building?

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Orientation place (floor)

What floor are we on?

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Registration1

SAY: I am going to name three objects. When I am finished, I want you to repeat them. Remember what they are because I am going to ask you to name them again in a few minutes. Say the following words slowly at 1‐second intervals: Zitrone/Pane

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Registration2

SAY: I am going to name three objects. When I am finished, I want you to repeat them. Remember what they are because I am going to ask you to name them again in a few minutes. Say the following words slowly at 1‐second intervals: Schlüssel/Casa

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Registration3

SAY: I am going to name three objects. When I am finished, I want you to repeat them. Remember what they are because I am going to ask you to name them again in a few minutes. Say the following words slowly at 1‐second intervals: Tisch/Gatto

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Attention1

Spell the word PREIS/CARNE. Now spell it backwards. 5th letter

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Attention2

Spell the word PREIS/CARNE. Now spell it backwards. 4th letter

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Attention3

Spell the word PREIS/CARNE. Now spell it backwards. 3rd letter

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Attention4

Spell the word PREIS/CARNE. Now spell it backwards. 2nd letter

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Attention5

Spell the word PREIS/CARNE. Now spell it backwards. 1st letter

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Recall1

Now what were the three objects I asked you to remember? Zitrone/Pane

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Recall2

Now what were the three objects I asked you to remember? Schlüssel/Casa

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Recall3

Now what were the three objects I asked you to remember? Tisch/Gatto

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Language1

SHOW wristwatch. ASK: What is this called?

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Language2

SHOW pencil. ASK: What is this called?

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Repetition

SAY: I would like you to repeat this phrase after me: "Kein wenn und oder aber"/"Tigre contro tigre"

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Commands (read)

SAY: Read the words on the page and then do what it says. SCHLIESSEN SIE IHRE AUGEN/ CHIUDA GLI OCCHI

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Commands (write)

SAY: Write any complete sentence on that piece of paper.

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Commands (draw)

SAY: Copy this design please.

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Commands (hand)

ASK the person if he is right or left‐handed. Take a piece of paper and hold it up in front of the person. SAY: Take this paper in your right/left hand (whichever is non‐dominant), fold the paper in half once with both hands and put the paper down on the floor. Takes paper correctly in hand

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Commands (fold)

ASK the person if he is right or left‐handed. Take a piece of paper and hold it up in front of the person. SAY: Take this paper in your right/left hand (whichever is non‐dominant), fold the paper in half once with both hands and put the paper down on the floor. Folds it in half

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Commands (table)

ASK the person if he is right or left‐handed. Take a piece of paper and hold it up in front of the person. SAY: Take this paper in your right/left hand (whichever is non‐dominant), fold the paper in half once with both hands and put the paper down on the floor. Puts it on the floor

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Registration (No. of trays)

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MMSE score

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Number of valid responses

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Note MMSE

MMSE notes

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MMSE version

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Cognition (CHRIS baseline)

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