Short Blessed (also called Short Orientation Memory Concentration Test)

Basic Information

• Title/Author(s):
  Short Blessed Test (SBT) (also called the Short Orientation-Memory-Concentration Test)
  Developed by: Robert Katzman, Terry Brown, Philip Fuld, Ann Peck, Robert Schechter, and Herbert Schimmel.
  
  

• Year of Development & Publisher:
  
  

  • Developed in 1983.
    
    

  • Publisher:
    
    

  • Freely available through universities and public health organizations (e.g., Alzheimer’s Association).
    
    

Assessment Details

• Identify TWO Types:
  
  

  • Screening tool
    
    

  • Performance-based, criterion-referenced
    
    

• Cost & How to Access:
  
  

  • Cost:
    
    

    • Free for clinical, educational, and research purposes.
      
      

  • Access:
    
    

    • Available at:
      Alzheimer’s Association - Short Blessed Test (SBT)
      
      

• Population & Setting:
  
  

  • Population:
    
    

    • Adults, primarily older adults at risk for mild cognitive impairment (MCI), dementia, or cognitive decline.
      
      

  • Settings:
    
    

    • Primary care offices, memory clinics, geriatrics clinics, skilled nursing facilities, and community health screenings.
      
      

• Purpose & Areas Assessed:
  
  

  • Purpose:
    
    

    • To briefly assess global cognitive functioning, focusing on orientation, memory, and attention.
      
      

  • Domains Assessed:
    
    

    • Orientation to time and place
      
      

    • Immediate recall and short-term memory
      
      

    • Attention/concentration (e.g., serial sevens subtraction)
      
      

Administration & Scoring

• Administration:
  
  

  • Time Required: 5–7 minutes
    
    

  • Format:
    
    

    • Individually administered with simple verbal prompts.
      
      

    • No need for special equipment or environment.
      
      

• User Qualifications:
  
  

  • Suitable for administration by occupational therapists, physicians, psychologists, nurses, and trained allied health professionals.
    
    

• Materials Required:
  
  

  • Printed form or verbal script
    
    

  • Pen/pencil for scoring
    
    

• Scoring:
  
  

  • 6 items scored using a weighted error system.
    
    

  • Total scores:
    
    

    • 0–4: Normal cognition
      
      

    • 5–9: Questionable impairment
      
      

    • 10 or more: Impairment consistent with dementia
      
      

  • Some errors (e.g., mistakes on date or place) are scored more heavily than minor mistakes.
    
    

Psychometrics/Standardization

• Reliability:
  
  

  • The Short Blessed Test demonstrates good internal consistency with a Cronbach's alpha reported around 0.83 in dementia research samples (Feldman et al., 2004).
    
    

  • High interrater reliability — scoring is very consistent between trained evaluators when standardized instructions are followed (Creavin et al., 2016).
    
    

• Validity:
  
  

  • Convergent validity:
    
    

    • Strong correlation with other cognitive screening tools like the Mini-Mental State Examination (MMSE) (r ≈ 0.80) (Feldman et al., 2004).
      
      

  • Discriminant validity:
    
    

    • Effectively distinguishes between individuals with normal cognition, mild cognitive impairment, and dementia.
      
      

  • Sensitivity and Specificity:
    
    

    • Sensitivity reported between 85–95% for moderate dementia cases.
      
      

    • Specificity slightly lower (~70–80%) depending on clinical setting (Creavin et al., 2016).
      
      

• Norms:
  
  

  • Informal norms exist, primarily drawn from older adult outpatient and memory clinic populations.
    
    

  • It is considered a brief global cognitive screen, not normed extensively for younger populations.
    
    

Critical Thinking Sections

Strengths

• Fast administration — Under 7 minutes for most patients.
  
  

• Highly sensitive to dementia — Effective for detecting moderate-to-severe cognitive impairment.
  
  

• Easy to train staff — Simple verbal script and minimal materials needed.
  
  

• Widely used and freely available — No licensing restrictions.
  
  

• Correlates well with gold-standard tools like the MMSE.
  
  

Weaknesses

• Less sensitive for very mild cognitive impairment (MCI) — May not detect subtle early cognitive changes.
  
  

• Influenced by education level and cultural factors — Scoring interpretation should consider these.
  
  

• Brief screening only — Does not provide a full neuropsychological profile.
  
  

• Weighted scoring can confuse new users — Requires careful attention to scoring rubric.