What Is Serial Sevens?

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  • Written By: Dan Harkins
  • Edited By: Kaci Lane Hindman
  • Last Modified Date: 14 November 2019
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Serial sevens is a cursory test of brain function that forms a small part of a widely used test to gauge a patient's level of consciousness. Counting backward from 100 in increments of seven requires concentration as well as short-term memory. Many clinicians have switched to subtractions of smaller increments, like three or five, after some studies have questioned the efficacy of this test for determining cognition.

The serial numbers test is customarily a part of what is known as a mini-mental exam, which is a frequently used tool used by physicians to quickly assess a person's mental capacity. It is also commonly used by staffers in elderly focused facilities like nursing homes and assisted living facilities, where the most people with conditions like dementia or Alzheimer's disease live. Serial sevens forms the cognition portion of the mini-mental exam.

Those who administer the mini-mental exam will often substitute serial fives or even serial threes for serial sevens. The smaller increments require the same kind of reverse mechanics. According to a 1997 study published online by the National Institutes of Health, just half of all non-impaired, fully conscious high school students who were administered the serial sevens test even passed it. By contrast, at least 79 percent passed the serial threes test, and 89 percent passed when asked to recite the calendar in reverse.


The researchers concluded that the original test was not adequate when attempting to gauge whether a young athlete has suffered a concussion. This is due to its lackluster score in relation to other cognition tests. Nevertheless, for older adults or clinicians, the test is still used to challenge the level of consciousness in older minds. It is only part of a much broader evaluation.

Other parts of the mini-mental exam gauge different components of a patient's brain function. An examiner may start by asking for orienting data regarding time — like the year, month and day, and space — like the state, city or name of the facility. Then a patient is led through a variety of memory and organization activities. A common memory test is being asked for three or even five members of a certain group, such as carrots, green peppers and celery in the vegetable family, then restating these items again. Three-part directions may be given to be followed, like, "Blink twice, open your mouth, and stick out your tongue." To test more advanced functions, a mini-mental test also may involve reading, drawing and reciting familiar phrases.


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