Skip to main content

Rehab Measures: Cognitive Log

Link to instrument 

Title of Assessment

Cognitive Log 



Instrument Reviewer(s)

Initially reviewed by Karen McCulloch, PT, PhD, NCS and the TBI EDGE task force of the Neurology Section of the APTA in 6/2012

Summary Date



The Cog-Log measures general cognitive abilities in a cursory way, designed to be used as a companion to the Orientation-Log (O-Log).


  • The Cog-Log includes the 3 most difficult orientation items from the O-Log, and 7 additional items that test other cognitive abililty:
    • 1. (O-Log) Name of facility
    • 2. (O-Log) Date
    • 3. (O-Log) Time of day
    • 4. Repeat an address
    • 5. Counting backwards from 20 to 1
    • 6. Reciting the months of the year in reverse order
    • 7. Estimating the passage of 30 seconds
    • 8. Repeat a motor sequence (fist-edge-palm)
    • 9. Raising finger to “red” and do nothing to “green”
    • 10. Address recall
  • Score: 0 to 30
  • Each item is scored from 0 to 3 based on specific criteria per item with score of 3 if the spontaneous response is correct; 2 if a correct response requires cueing; 1 if a correct response requires multiple choice; 0 if a correct response is not obtained
  • Administration instructions are described on the COMBI website (see link above)

Area of Assessment


Body Part


ICF Domain

Body Structure; Body Function 



Assessment Type


Length of Test

06 to 30 Minutes 

Time to Administer

5 minutes for someone who performs well, up to 10 minutes for someone who is confused and requires cueing and prompting.

Number of Items

10 items 

Equipment Required

  • Stopwatch
  • Scoresheet includes a graph where serial assessments can be plotted for visual analysis

Training Required

No specific training is required.

Type of training required

No Training 



Actual Cost


Age Range


Administration Mode



Acquired Brain Injury; Traumatic Brain Injury 

Populations Tested

  • Traumatic Brain Injury
  • Acquired Brain Injury

Standard Error of Measurement (SEM)

Aquired Brain Injury: (Alderson and Novack, 2003; n=82 patients with brain injury and 82 controls matched for age, education and gender; total sample included 150 patients with ABI, 80% moderate to severe, mean age 45(18.7) years)

  • SEM no more than .10 for single item scores, which range from 0 to 3
  • SEM for the total score of .53 (ranges 0 to 30).

Minimal Detectable Change (MDC)

Not Established

Minimally Clinically Important Difference (MCID)

Not Established

Cut-Off Scores

Acquired Brain Injury: (Alderson & Novack, 2003)

  • A cut-off score of 25 correctly classified 88.4% in the appropriate group (brain injury vs. controls)

Normative Data

Healthy controls: (Alderson & Novack, 2003; n=83 young adults, mean age 22.73 (5.82) years without ABI)

  • Mean =28 (2) with mean individual item scores > 2.4

Test-retest Reliability

Not Established

Interrater/Intrarater Reliability

Acquired brain injury: (Alderson & Novack, 2003; subset of 19 patients with 75 observations)

  • Adequate to excellent inter-rater reliability with Spearman’s rho coefficients ranging from .749 (go/no-go task) to 1.0 (time estimation)

Internal Consistency

Acquired Brain Injury: (Alderson & Novack, 2003)

  • Excellent internal consistency (Chronbach’s alpha= .778)

Criterion Validity (Predictive/Concurrent)

Criterion validity:

Aquired Brain Injury: (Penna et al, 2007; n=45 patients with moderate to severe ABI in inpatient rehabilitation; mean age=39.7(18.5) years)

  • Cog-Log correlates significantly with the MiniMentalStateExam r=.75, and with the O-Log r=.65

 Predictive validity:

Traumatic Brain Injury: (Lee et al, 2004; n=50 patients with TBI, mean age 35.2(14.9) years)

  • Lowest Cog-Log scores during acute rehab for patients with moderate to severe TBI predicted cognitive outcome at one year post-injury for:
    • Attention (delta r2=.10)
    • Executive function (delta r2=.11)
    • Visuomotor/spatial function (delta r2=.16)

Construct Validity (Convergent/Discriminant)

Construct Validity:

Acquired Brain Injury: (Alderson & Novack, 2003)

  • Cog-Log scores significantly associated with neuropsych measures of verbal and working memory, and executive function (p=.004-<.001)

Content Validity

Traumatic brain injury:

  • Factor analysis demonstrated loading on a single factor with eigenvalue 3.48, which authors attributed to complex working memory and long term recall. (Alderson & Novack, 2003)

Face Validity

Acquired Brain Injury: (Alderson and Novack, 2003)

  • Items of the Cog-Log are very similar to those described by Katzman et al, 1983, validated as a short cognitive test for older adults.

Floor/Ceiling Effects

Acquired Brain Injury: (Alderson and Novack, 2003)

  • Not specifically studied, but developers suggest it is best not to use Cog-Log unless O-Log score is 15 or greater (possible floor effect with Cog-Log if individual is too confused)
  • If O-Log score is between 15 and 25, use the O-Log and Cog-Log together
  • Once O-Log score is 25 or greater for 2 test administrations, the Cog-Log can be used by itself
  • The use of cuing and multiple choice responses is cited as a benefit to reduce floor effects, since partial credit is possible for responses based on cuing


Not Established

Professional Association Recommendations

Measure: Cognitive Log


Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (VEDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.


For detailed information about how recommendations were made, please visit:




Highly Recommend




Reasonable to use, but limited study in target group  / Unable to Recommend


Not Recommended


Recommendations based on level of care in which the assessment is taken:


Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility



Home Health








Recommendations for use based on ambulatory status after brain injury:


Completely Independent

Mildly dependant

Moderately Dependant

Severely Dependant







Recommendations for entry-level physical therapy education and use in research:


Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)





Not reported


Developers are clear that they do not intend the Cog-Log to replace or substitute for neuropsychological testing or other cognitive performance scales, suggesting the Cog-Log is a simple tool that can easily be used bedside to track progression of orientation and cognitive improvements. The test can be done without writing, which is sometimes a problem for other cognitive tests.
Do you see an error or have a suggestion for this instrument summary? Please e-mail us!


Alderson, A. L. and Novack, T. A. (2003). "Reliable serial measurement of cognitive processes in rehabilitation: the Cognitive Log." Arch Phys Med Rehabil 84(5): 668-672. Find it on PubMed

Katzman, R., Brown, T., et al. (1983). "Validation of a short Orientation-Memory-Concentration Test of cognitive impairment." Am J Psychiatry 140(6): 734-739. Find it on PubMed

Lee, D., LoGalbo, A. P., et al. (2004). "Prediction of Cognitive Abilities 1 Year Following Traumatic Brain Injury From Inpatient Rehabilitation Cognitive Screening." Rehabilitation Psychology 49(2): 167.

Penna, S. and Novack, T. A. (2007). "Further validation of the Orientation and Cognitive Logs: their relationship to the Mini-Mental State Examination." Arch Phys Med Rehabil 88(10): 1360-1361. Find it on PubMed

Year published


Instrument in PDF Format

Approval Status Approved 
Created at 11/29/2012 2:10 PM  by Jason Raad 
Last modified at 9/3/2014 9:59 AM  by Jason Raad