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Brief Interview For Mental Status (BIMS) Calculator

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By Admin, Admin

Published On April 1, 2024

Evaluates cognitive impairment and can help with dementia diagnosis.
In the text below the calculator there is more information about this evaluation method.

Purpose

The Brief Interview for Mental Status (BIMS) is used to assess cognitive status in elderly patients and may provide useful information as to whether the patient should be referred for dementia diagnosis investigations.

Key Facts

The following table summarizes the BIMS scores:

BIMS Score Interpretation
0 – 7 Severe cognitive impact
8 – 12 Moderate impairment
13 – 15 Intact cognitive response

The closer the score is to 0, the greater the cognitive impact.

  • Part 1 - Repetition of three words

    Inform the resident that you are going to say three words and that he or she needs to remember the words and to repeat them. Say the three words: sock, blue and bed. Ask the resident to reproduce the three words and note the number after the first attempt:

  • Part 2 - Temporal orientation

    a. Ask the resident what year is it right now and report their answer:

  • b. Ask the resident what month we are in at the moment and report their answer:

  • c. Ask the resident what day of the week is today and report their answer

  • Part 3 - Recall

    Tell the resident that you are going back to the earlier question and ask them to say the words that they were asked to repeat. If they are unable to remember a word, provide cues such as "something to wear", "a color", "a piece of furniture"

    a. Able to recall "sock"

  • b. Able to recall "blue"

  • c. Able to recall "bed"

Result interpretation

Each of the seven items that BIMS consists of, is awarded a number of points ranging from 0 to 3. The higher the score, the lower the impairment to the cognitive response. Scores closer to 0 indicate severe cognitive impact whilst scores closer to 15 indicate an intact cognitive response:

BIMS ScoreInterpretation
0 – 7Severe cognitive impact
8 – 12Moderate impairment
13 – 15Intact cognitive response

In some cases, due to extreme frailty, hearing impairment or lack of interaction during the assessment, the result may not accurately reflect the cognitive status of the patient.

Between subsequent evaluations, a decline in score of even 1 to 2 points shows a notable mental status change.

This type of evaluation is an initial one and should be followed by more specialized investigations, especially for dementia diagnosis.

The BIMS is correlated with results from other scales such as the MMSE (Mini-Mental State Exam). If the elderly patient also displays
behavioural symptoms linked to depression, they may be referred to take the Geriatric Depression Scale (GDS).

Very serious and time abrupt changes in behaviour and mental status (e.g. delirium) may indicate an underlying condition.

BIMS explained

The Brief Interview for Mental Status (BIMS) is a structured evaluation aimed at evaluating aspects of cognition in elderly patients. The three parts of the assessment look at:

  • Patient attention
  • Level of orientation;
  • Ability to recall information.

The use of BIMS has contributed to a decrease in incorrect diagnosis of cognitive impairment and a more specific detection of dementia and delirium.

The method is now performed on a quarterly basis in nursing homes all over the world.

There are three assessment stages in the BIMS assessment:

  • During part I, the patient is asked to repeat three words that are to be given by the assessor. The accuracy of the word reproduction is assessed. Also, the patient is informed that they will need to remember the words at a later moment during the evaluation.
  • During part II, temporal orientation is evaluated by asking the patient to recall temporary coordinates (current year, month and day of the week). These are to be asked in separate questions and about 30 seconds are to be given for response
  • During part III the patient is asked to recall the three words given in part I. If needed, cues may be given after waiting for 5 seconds for spontaneous recall.

The main criticism of the method refers to the fact that it doesn’t assess cognition as a whole and cannot evaluate executive functions.

References

1. Saliba D, Buchanan J, Edelen MO, Streim J, Ouslander J, Berlowitz D, Chodosh J. MDS 3.0: brief interview for mental status. J Am Med Dir Assoc. 2012; 13(7):611-7.

2. Mansbach WE, Mace RA, Clark KM. Differentiating levels of cognitive functioning: a comparison of the Brief Interview for Mental Status (BIMS) and the Brief Cognitive Assessment Tool (BCAT) in a nursing home sample. Aging Ment Health. 2014; 18(7):921-8.

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