Table of ContentsView AllTable of ContentsSectionsScoringInterpretationAccuracyUses
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Table of Contents
Sections
Scoring
Interpretation
Accuracy
Uses
BIMS stands for Brief Interview for Mental Status. The BIMS test is used to get a quick snapshot of how well you are functioning cognitively at the moment. A BIMS score can range from 0 to 15, with lower scores indicating a decline in cognitive performance.
It is a required screening tool used in nursing homes and other long-term care facilities to assess cognition.Because the BIMS is given every quarter, the scores can help measure if you’re improving, remaining the same, or declining in cognitive ability.
This article explains how the BIMS test works. It covers how test results are scored and interpreted, along with how healthcare providers can use the results to tailor your care.
Verywell / Laura Porter
Components of the BIMS Test
There are three sections in the BIMS assessment.
The first section of the BIMS assesses immediate recall. The test administrator will speak three words, like “sock,” “blue,” and “bed,” which you will then repeat back.
The second section of the BIMS assessesorientation. You will be asked to identify what month we are in currently, which year it is, and what day of the week it is.
The third section of the BIMS assessesshort-term memory. After the distracting task of orientation questions, you will be asked to recall the three words you had to repeat earlier. If you can’t recall the words, you will be given a cue to help trigger the memory, such as “something to wear” to determine if that helps you to recall and say the word “sock.”
What BIMS Scores Mean
The BIMS assessment uses a points system that ranges from 0 to 15 points:
Test takers begin with zero points and are awarded 1 point for each correct response they give.
Immediate Recall Test
For the immediate recall test, 1 point is assigned for each of the three words repeated correctly for a maximum of 3 points.
Example:The test administrator says the words “sock,” “blue,” and “bed.” When prompted to repeat them back, the test taker is only able to repeat the word “bed.” The test taker is given 1 point for this section.
Orientation Test
For the orientation test, between 1 and 3 points are assigned for each of the three sections for a maximum of 6 points.
Identification of the Year
Identification of the Month
Identification of the Day of the Week
Example:The test taker is asked to speak the present year, month, and day of the week. They correctly identify the year and are awarded 3 points. The test taker incorrectly identifies the month and is awarded 1 point. They correctly identify the day of the week and are awarded 1 point. In total, the test taker gets 5 points for this section.
Short-Term Memory Test
The short-term memory test offers a maximum of 6 points. For this section, between 0 and 1 points are assigned for each of three words based on whether you:
Example:The test taker is asked to repeat the initial three words given in the immediate recall section. They can recall all three words, but only with cues. The test taker is awarded 3 points for this section, bringing their total BIMS score to 9 points.
Interpreting the BIMS Score
The BIMS is most often used as part of an assessment tool called the Minimum Data Set (MDS) in nursing homes.The BIMS is conducted periodically to assess cognition over time.
While the BIMS is not used to diagnosedementia, it can help identify changes in cognition over time. Significant deterioration of a BIMS score may trigger other, morecomprehensive evaluationsfor dementia.
The BIMS score can also help identify some basic needs of the person. For example, if you are unable to repeat the three words in the first section of the test, perhaps you have a hearing impairment or you are unable to communicate verbally.
Alternately, if you are only able to remember the three words at the end of the test when the cues are provided, this can be a reminder to staff members that offering verbal or visual cues may be helpful in your activities of daily living.
Accuracy of the BIMS Score
The BIMS assesses limited areas in cognition and thus it does not give a fully accurate picture of cognition.
A person may appear to be higher functioning because the BIMS does not assess other areas of cognition such asexecutive functioning.
However, research does indicate that it is a more reliable way to screen for cognitive functioning than simple observation. Other methods for predicting cognitive stages are also available.
How BIMS Scores Are Used
Moreover, it allows caregivers to know when it is time for more active intervention. A decline in score, for example, a 13 to a 9, demonstrates a notable change in mental abilities. A sudden decline in the BIMS score could help point out a condition such asdelirium.
Delirium sometimes develops frominfections, includingurinary tract infectionsand pneumonia. Prompt identification and treatment can often partially or fully restore cognitive functioning to its level prior to the delirium.
Summary
The Brief Interview for Mental Status (BIMS) is an assessment used in nursing homes and other long-term care facilities to monitor cognition. The assessment involves three sections with the ultimate purpose of testing short-term word recall and orientation in time. Test scores range from 0, suggesting severe cognitive impairment, to 15, suggesting intact cognition. The BIMS tests some areas of cognition, but not all. Nonetheless, it is a valuable tool for healthcare providers to identify and treat changes in mental abilities.
How Dementia Is Diagnosed
3 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Thomas KS, Dosa D, Wysocki A, Mor V.The Minimum Data Set 3.0 Cognitive Function Scale.Med Care. 2017;55(9):e68–e72. doi:10.1097/MLR.0000000000000334Brief Interview for Mental Status.PDF 10/11Mace RA, Mansbach WE, Clark KM.Rapid cognitive assessment of nursing home residents: A comparison of the Brief Interview for Mental Status (BIMS) and Brief Cognitive Assessment Tool-Short Form (BCAT-SF).Res Gerontol Nurs. 2016;9(1):35-44. doi:10.3928/19404921-20150522-05Additional ReadingThe BCA: Home of the Brief Cognitive Assessment.American Association of Post-Acute Care Nursing. CMS’s RAI Version 3.0 Manual.Centers for Medicare and Medicaid Services.Minimum Data Set (MDS) 3.0 Resident Assessment Instrument(RAI) Manual.Maine Department of Human Services.Minimum Data Set Training: Section C Cognitive Patterns (BIMS).Maryland Medicaid Website. Long Term Care Resources. Brief Interview for Mental Status (BIMS) - Form & Instructions.
3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Thomas KS, Dosa D, Wysocki A, Mor V.The Minimum Data Set 3.0 Cognitive Function Scale.Med Care. 2017;55(9):e68–e72. doi:10.1097/MLR.0000000000000334Brief Interview for Mental Status.PDF 10/11Mace RA, Mansbach WE, Clark KM.Rapid cognitive assessment of nursing home residents: A comparison of the Brief Interview for Mental Status (BIMS) and Brief Cognitive Assessment Tool-Short Form (BCAT-SF).Res Gerontol Nurs. 2016;9(1):35-44. doi:10.3928/19404921-20150522-05Additional ReadingThe BCA: Home of the Brief Cognitive Assessment.American Association of Post-Acute Care Nursing. CMS’s RAI Version 3.0 Manual.Centers for Medicare and Medicaid Services.Minimum Data Set (MDS) 3.0 Resident Assessment Instrument(RAI) Manual.Maine Department of Human Services.Minimum Data Set Training: Section C Cognitive Patterns (BIMS).Maryland Medicaid Website. Long Term Care Resources. Brief Interview for Mental Status (BIMS) - Form & Instructions.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Thomas KS, Dosa D, Wysocki A, Mor V.The Minimum Data Set 3.0 Cognitive Function Scale.Med Care. 2017;55(9):e68–e72. doi:10.1097/MLR.0000000000000334Brief Interview for Mental Status.PDF 10/11Mace RA, Mansbach WE, Clark KM.Rapid cognitive assessment of nursing home residents: A comparison of the Brief Interview for Mental Status (BIMS) and Brief Cognitive Assessment Tool-Short Form (BCAT-SF).Res Gerontol Nurs. 2016;9(1):35-44. doi:10.3928/19404921-20150522-05
Thomas KS, Dosa D, Wysocki A, Mor V.The Minimum Data Set 3.0 Cognitive Function Scale.Med Care. 2017;55(9):e68–e72. doi:10.1097/MLR.0000000000000334
Brief Interview for Mental Status.PDF 10/11
Mace RA, Mansbach WE, Clark KM.Rapid cognitive assessment of nursing home residents: A comparison of the Brief Interview for Mental Status (BIMS) and Brief Cognitive Assessment Tool-Short Form (BCAT-SF).Res Gerontol Nurs. 2016;9(1):35-44. doi:10.3928/19404921-20150522-05
The BCA: Home of the Brief Cognitive Assessment.American Association of Post-Acute Care Nursing. CMS’s RAI Version 3.0 Manual.Centers for Medicare and Medicaid Services.Minimum Data Set (MDS) 3.0 Resident Assessment Instrument(RAI) Manual.Maine Department of Human Services.Minimum Data Set Training: Section C Cognitive Patterns (BIMS).Maryland Medicaid Website. Long Term Care Resources. Brief Interview for Mental Status (BIMS) - Form & Instructions.
The BCA: Home of the Brief Cognitive Assessment.
American Association of Post-Acute Care Nursing. CMS’s RAI Version 3.0 Manual.
Centers for Medicare and Medicaid Services.Minimum Data Set (MDS) 3.0 Resident Assessment Instrument(RAI) Manual.
Maine Department of Human Services.Minimum Data Set Training: Section C Cognitive Patterns (BIMS).
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