Our aim is to discuss the use of cognitive assessment tools in generational cohorts with high rates of illiteracy. The scales used to evaluate the cognitive impairment were the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Three items were added to assess the domain of language.

The sample included 224 institutionalized elderly from municipality of Miranda do Corvo - Portugal, mean age of 83.76 years (± 7.29), 179 were women (79.9%), and 93 (41.5%) had no education.

The assessment took place between December 2011 and May 2012 and showed that people had high levels of cognitive impairment. The difference was proved to be statistically significant regardless the considered age cuts of 65, 65–74 or 75. Through the MMSE, we found that 55 of the 144 respondents (38.2%) had cognitive impairment. If we add the other elderlies diagnosed with dementia, the prevalence rises to 60.3%. The evaluation conducted by MoCA showed that 140 (97.2%) of the elderly had cognitive impairment. If we add to these the remaining respondents diagnosed with dementia, this percentage rises to 98.2%.

The results were related to the sociodemographic characteristics of this generational cohort and attested the prevalence of cognitive impairment in institutions for elderly people.

Thus, we propose that institutions implement cognitive stimulation programs for the maintenance and improvement of cognitive abilities of the elderly, and we methodologically discuss the use of these scales to the measure of the cognitive impairment.