©2009, Sharon K. Inouye, M.D., MPH, Aging Brain Center, Hebrew Rehabilitation Center

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SWEET 16 INSTRUMENT !

Score 1. What is the year? __________ 1

2. What is the date? __________ 1

3. What is the day of the week? __________ 1

4. What is the month? __________ 1

5. Can you tell me where we are? (What is the name of this place?) __________ 1

6. What city are we in? __________ 1

7. What state are we in? __________ 1

8. What floor of the hospital are we on?

(What room of the house are we in?)? ___________ 1

9-11. I am going to name 3 objects. After I have said them, 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. The three items are: “Apple”….”Table”….”Penny”. [PRESENT WORDS CLEARLY AND SLOWLY. WORDS MAY BE PRESENTED UP TO 4 TIMES, BUT SCORE ONLY ITEMS REPORTED AFTER FIRST PRESENTATION]

APPLE __________ 1

TABLE __________ 1

PENNY __________ 1

12-13. Now I am going to say some numbers. Please repeat them back to me.

[SAY DIGITS AT RATE OF ONE PER SECOND]

2 - 4 - 9 __ - __ - __ [0] 0

8 - 5 - 2 - 7 __ - __ - __ - __ [0] 0

Now I am going to say some more numbers. But this time, when I stop, I want you to say them backward. For example, if I say 7-1-9, what would you say? [IF RESPONSE IS INCORRECT REPEAT DIRECTIONS AGAIN ONE TIME ONLY. SAY DIGITS AT RATE OF ONE PER SECOND. ONCE STATED, DO NOT REPEAT NUMBERS]

4 - 1 - 5 __ - __ - __ [1] __________ 1

3 - 2 - 7 - 9 __ - __ - __ - __ [1] __________ 1

14-16. Now, what are the 3 objects I asked you to remember?

APPLE __________ 1

TABLE __________ 1

PENNY ___________ 1

TOTAL SCORE: ______________/ 16