Calculation is an inevitable part of all examinations of higher cerebral function. Difficulties with numbers, words, and concentration are among the most common presenting symptoms in dementia.
Ask the patient to immediately repeat back to you a series of random, single-digit numbers.
Start with three numbers (eg, 7, 4, and 9), then four, and continue. Repetition by most people reveals recollection of seven digits forward and five backward. (This is a test more of concentration than of numerical skill, but it is a good way to start. Tests consisting of numbers seem to intimidate most people.)
100 Minus 7
Ask the patient to subtract 7 from 100, to tell you the result, and then subtract 7 from 93, 7 from 86, and so on.
Most people can do this in about 90 s with no errors.
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