BIMS Calculator – Brief Interview for Mental Status

Created by Mariamy Chrdileli
Reviewed by Łucja Zaborowska, MD, PhD candidate and Steven Wooding
Based on research by
Saliba D, Buchanan J, Edelen MO, Streim J, Ouslander J, Berlowitz D, Chodosh J. MDS 3.0: brief interview for mental status Journal of the American Medical Directors Association (2012)
Last updated: Oct 20, 2022

Welcome to Omni's BIMS calculator, a convenient tool you can use to implement cognitive assessment in nursing homes.

Approximately half of all residents in nursing homes meet the criteria for dementia or have some type of cognitive impairment. Assessing and identifying residents with cognitive impairment is essential for developing effective care plans and interventions. The brief interview for mental status (BIMS) is a great tool designed for briefly evaluating residents' cognitive functioning in a short time.

Keep reading the article to get answers to some of the critical questions, such as:

  • What is the BIMS test?
  • Where is the BIMS assessment tool most utilized?
  • How do you interpret the BIMS score?
  • How does the BIMS calculator work? And more!

What is the brief interview for mental status?

The brief interview for mental status (BIMS) is a performance-based standardized cognitive assessment primarily utilized in nursing homes. The BIMS takes around 3 minutes to administer and assesses three domains of cognitive function: memory, orientation, and judgment. The BIMS test is an efficient tool that can be implemented by paraprofessionals and licensed clinicians alike.

Note that the BIMS test is not the most suitable tool for assessing executive capacities or milder forms of cognitive impairment. Further investigations should follow the BIMS assessment to determine an underlying condition. You can also use barthel index calculator to screen for daily self-care and mobility.

The BIMS score interpretation

The BIMS total score can range from 0-15, with a higher score indicating intact cognitive response and a lower score suggesting cognitive impairment. A more detailed interpretation of the results is as follows:

Score

Interpretation

0-7

Severe cognitive impact.

8-12

Moderate impairment.

13-15

Intact cognitive response.

If the patient shows a decline of 1 to 2 points in performance between subsequent evaluations, the result should be considered a significant mental status change.

Did you know that depression may affect cognitive functioning? Use our depression screening by PHQ-2 calculator to see whether your patient struggles with depressive symptomatology.

How does the BIMS calculator work?

The BIMS calculator has three sections:

  1. The repetition of three words.
  2. Exploration of the patient's/resident's temporal orientation (the knowledge of the year, month, and day of the week).
  3. Recall.

You should follow the instructions for each section and carefully select appropriate scoring according to the resident's response. For instance, in the recall section, if the resident cannot recall any words you asked to repeat previously, you would mark "No, could not recall" for each word.

After scoring the resident's responses, the Omni BIMS calculator will compute the total score and suggest the BIMS score interpretation. If you're working with an elderly group of patients, you may also find our tinetti calculator and geriatric BMI calculator helpful to check for gait and balance abilities and body mass index, respectively.

FAQ

What are other tools similar to the BIMS assessment?

Other tools similar to the BIMS include:

  • Brief cognitive assessment tool (BCAT) – A multi-domain screening tool for cognitive dysfunction assessing contextual memory, executive functions, and attentional capacity; and

  • Montreal cognitive assessment (MoCA) – One of the most popular screening tools for identifying cognitive decline. The assessment involves tasks related to short-term memory, language, abstraction, executive function, attention, etc.

How do I interpret the BIMS test?

Interpretation of the BIMS is quite straightforward:

  1. Add all points to compute the final score.
  2. Check whether the score fits in the following categories:
    • 0 to 7 – Severe cognitive impact;
    • 8 to 12 – Moderate impairment; or
    • 13 to 15 – Intact cognitive response.
  3. That's all! You now have the BIMS score interpretation.

What does a BIMS score of 13 mean?

A score of 13 on the brief interview for mental status indicates that a patient is cognitively intact. Although note that the BIMS may not differentiate between those with average and mild cognitive impairment.

What is 3 word recall test in the BIMS?

The 3-word recall test is the last task in the brief interview for mental status, assessing short-term memory. In the task, the administrator of the test asks the resident to recall words from the first task. If the resident cannot remember anything, the administrator can provide cues.

Mariamy Chrdileli
Basic instructions for the BIMS:

It would be best to conduct the interview in a quiet, private setting. Ensure you introduce the test to the resident and that the resident does not have a hearing problem. If the resident has a hearing impairment, offer alternative modes of communication, such as writing or cue cards.


Part I – Repetition of three words

Inform the resident that you will say three words and that they need to remember the words and repeat them. Say the three words, e.g., sock, blue, and bed. Ask the resident to reproduce the three words and note the number after the first attempt:
All words repeated
Part II – Temporal orientation

A. Ask the resident what year it is right now and report their answer:
Correct
B. Ask the resident what month we are in at the moment and report their answer:
Accurate within 5 days
C. Ask the resident what day of the week it is today and report their response:
Correct
Part III – 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”?
Yes, no cue required
B. Able to recall “blue”?
Yes, no cue required
C. Able to recall “bed”?
Yes, no cue required
BIMS score
15
According to the score of 15 points, the patient has an intact cognitive response.
❗ Note the BIMS cannot be used to diagnose dementia. The tool only assesses various aspects of cognition in the elderly population. To learn more about the scale, click here.
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