Brief Interview for Mental Status (BIMS)

The purpose of the brief interview for mental status (BIMS) is to assess elderly individuals suspected of having dementia.  It can be used as an early detection test if you suspect someone has dementia.  It should be administered by a healthcare professional who has experience administering the BIMS interview.

What is the Brief Interview for Mental Status (BIMS)?

The BIMS interview is used more frequently in long term care (LTC) homes on elderly individuals suspected of dementia because it is a more reliable test.  It leads to more accurate diagnoses of dementia, and the suspected level of cognitive impairment.

Patient’s in LTC homes are assessed at minimum every three months using the BIMS interview as a part of their regular health assessments.  

It focuses on assessing 3 specific areas; patient’s attention ability, their level of orientation, and ability to recall information.

It is also composed of three stages.

In stage 1 the patient is asked to repeat three words, they will also need to remember these three words later on in the interview.  They are graded based on the accuracy of their pronunciation of the words.

In stage 2 the patient is asked to recall the current year, month, date and day.  This assesses their temporal orientation if they are aware of their current situation.  Each time period should be asked separately, and 30 seconds apart.  For example, ask if they know what month it is and wait 30 seconds to ask the date.

In stage 3 the patient is asked to repeat the words they were asked to remember in stage 1.  If they can’t answer within 5 seconds, the interviewer can give assistance.

Brief Interview for Mental Status Ranges

The BIMS score is calculated based on the individual’s performance on three key tasks: repetition of three words, temporal orientation (year, month, day, and season), and recall of the three words. Each task is weighted equally, contributing to the overall score.

Cutoff Scores for Cognitive Impairment

While the interpretation of BIMS scores may vary depending on the specific context and population, generally accepted cutoff scores for cognitive impairment are as follows:

The Scoring Range

It’s important to note that these cutoff scores serve as guidelines and should be interpreted within the broader context of the individual’s medical history, functional abilities, and other relevant factors.

Interpreting the Results

Visible in the chart above, the BIMS interview is on a scale of 0-15, a score closer to 0 indicates severe cognitive impairment.  Also recognized as severe levels of dementia.

Each question asked in the interview is given a score from 0-3.  If the patient scores close to 0, this indicates that their cognitive impairment is severe.  A higher score indicates they have either intact cognition or moderate impairments.  

If a patient is suspected after this interview of having a cognitive impairment, they should be further evaluated.  The BIMS is correlated with the mini mental state examination (MMSE), and can be used in place of it.

If a patient is suspected of having depression, you should refer to our Geriatric Depression Scale Test to evaluate.

If there are any suspected underlying health conditions, a healthcare professional should evaluate for this as well.

Explanations of Different Score Ranges

Scores of 13-15: Individuals scoring within this range are typically considered to have intact cognitive abilities or minimal impairment. They may exhibit some normal age-related changes but are generally able to function independently.

Scores of 8-12: This range suggests the presence of moderate cognitive impairment. Individuals in this range may experience difficulties with memory, orientation, and attention, which could impact their ability to perform daily activities or follow complex instructions.

Scores of 0-7: A score within this range indicates severe cognitive impairment. Individuals scoring in this range are likely to require significant assistance and support in their daily lives, as they may struggle with basic tasks, memory, and orientation.

It’s crucial to interpret BIMS scores in conjunction with a comprehensive evaluation by a qualified healthcare professional. The BIMS is a screening tool and should not be used as a standalone diagnostic measure. Further assessments and investigations may be necessary to determine the underlying cause of any observed cognitive impairment and develop an appropriate treatment or care plan.

Brief Interview for Mental Status (BIMS) Interview Questions

Stage 1 Interview: Question Repetition

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:

No word repeated = 0

1 word repeated = 1

2 words repeated = 2

3 words repeated = 3

Stage 2 Interview: Temporal Orientation

Ask the patient what year it is right now:

Missed by >5 years = 0

Missed by 2-5 years = 1

Missed by 1 year = 2

Correct = 3

Ask the patient what month it is right now:

Miss by >1 month or no answer = 0

Missed by 6 days to 1 month = 1

Accurate within 5 days = 2

Ask the patient what day of the week it is right now:

Incorrect or no answer = 0

Correct = 1

Stage 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”

Able to recall ‘sock’

No could not recall = 0

Yes, after cueing ‘something to wear’ = 1

Yes, no cue required = 2

Able to recall ‘blue’

No could not recall = 0

Yes, after cueing ‘color’ = 1

Yes, no cue required = 2

Able to recall ‘bed’

No could not recall = 0

Yes, after cueing ‘a piece of furniture’ = 1

Yes, no cue required = 2

How to Use the BIMS Calculator

Our BIMS Calculator is designed to be intuitive and user-friendly, making the cognitive assessment process seamless and efficient. Follow these simple steps to unlock the power of this valuable tool:

Step 1: Open the BIMS Calculator

Access our BIMS Calculator through your preferred device – whether it’s a computer, tablet, or smartphone. The calculator’s responsive design ensures a smooth experience across all platforms.

Step 2: Follow the Prompts

The calculator will guide you through the BIMS assessment, presenting you with a series of questions and tasks to administer to the individual being evaluated.

Step 3: Input Responses

As you conduct the BIMS interview, simply input the individual’s responses directly into the calculator. This can be done in real-time, ensuring accurate data collection and minimizing the risk of transcription errors.

Step 4: Record Additional Information (Optional)

Depending on your specific needs, you may have the option to record additional notes or observations related to the individual’s performance or behavior during the assessment.

Step 5: Calculate the BIMS Score

Once you’ve completed the interview and entered all necessary information, the BIMS Calculator will automatically tabulate the individual’s score based on the standardized BIMS scoring criteria.

The BIMS score, ranging from 0 to 15, provides a quantitative measure of the individual’s cognitive function. This score is instantly displayed, eliminating the need for manual calculations and reducing the potential for scoring errors.

With its intuitive design and automated scoring capabilities, our BIMS Calculator streamlines the assessment process, ensuring accurate and reliable results every time.

Features of Our BIMS Calculator

At the core of our BIMS Calculator is a commitment to providing a user-friendly experience that streamlines the cognitive assessment process. We’ve carefully designed our calculator to incorporate features that ensure accuracy, efficiency, and convenience, making it an invaluable tool for healthcare professionals, researchers, and caregivers alike.

User-Friendly Interface

Our BIMS Calculator boasts an intuitive and visually appealing interface, ensuring a seamless experience for users of all technical backgrounds. The clean and organized layout guides you through each step of the assessment, minimizing confusion and reducing the potential for errors.

Real-Time Scoring

One of the standout features of our calculator is its ability to provide real-time scoring. As you input the individual’s responses during the assessment, the calculator instantly calculates and updates the BIMS score. This real-time feedback eliminates the need for manual calculations, saving valuable time and ensuring accurate scoring.

Printable Results for Record-Keeping

Maintaining thorough and organized records is crucial in healthcare settings and research studies. Our BIMS Calculator offers the option to generate printable results, allowing you to easily document the individual’s performance, scores, and any additional notes or observations. This feature promotes efficient record-keeping and facilitates seamless communication among healthcare teams or research collaborators.

By incorporating these user-centric features, our BIMS Calculator not only enhances the assessment experience but also promotes consistency, accuracy, and efficiency throughout the cognitive screening process.

When to Use the BIMS Calculator

The versatility of our BIMS Calculator makes it a valuable tool across a wide range of settings and applications. Whether you’re a healthcare professional, researcher, or caregiver, this calculator can streamline cognitive assessments and provide reliable data to support informed decision-making.

Screening in Healthcare Settings

In various healthcare environments, such as hospitals, clinics, and long-term care facilities, the BIMS Calculator can be utilized as a screening tool to identify potential cognitive impairments. By administering the brief assessment during routine check-ups or initial evaluations, healthcare providers can quickly gauge an individual’s cognitive status and determine if further assessments or interventions are necessary.

Monitoring Cognitive Function Over Time

For individuals with known cognitive impairments or those at risk of developing cognitive issues, the BIMS Calculator can be instrumental in monitoring cognitive function over time. Regular assessments using the calculator can help track changes in cognitive abilities, enabling healthcare professionals to adjust treatment plans or implement appropriate support measures as needed.

Research and Clinical Studies

In the realm of research and clinical studies, the BIMS Calculator can be an invaluable tool for data collection and analysis. Researchers investigating cognitive function, aging, or neurological disorders can leverage the calculator to obtain standardized and reliable data from study participants. This data can then be used to identify patterns, test hypotheses, and contribute to the advancement of scientific knowledge in these areas.

Regardless of the setting or application, our BIMS Calculator ensures consistency, accuracy, and efficiency throughout the cognitive assessment process. By incorporating this powerful tool into your workflow, you can make informed decisions, track progress, and ultimately provide better care and support for individuals with cognitive impairments.

Limitations and Considerations

While valuable, our BIMS Calculator has some limitations:

• The BIMS is a screening tool, not a diagnostic test for conditions like dementia. Positive screenings require further evaluation.
• Performance can be influenced by factors like education, culture, language proficiency, and emotional/physical state.
• Interpretation of results should be done by trained healthcare professionals who can contextualize scores with the individual’s overall profile.

Conclusion

Our user-friendly BIMS Calculator streamlines cognitive screening, saving time and ensuring consistent, accurate scoring. Suitable for healthcare settings, research studies, and clinical trials, it efficiently screens for potential impairments and monitors cognitive function.

However, recognize the BIMS as a screening tool requiring professional interpretation. Individual factors should be considered, and positive screenings may warrant additional diagnostic testing.

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.