Mini-mental state examination

Mini-Mental State Examination

The Mini-Mental State Examination (MMSE) is a widely used test of cognitive function among the elderly; it includes tests of orientation, attention, memory, language and visual-spatial skills. The MMSE was introduced by Marshall Folstein, Susan Folstein, and Paul R. McHugh in 1975 as a practical method for grading the cognitive state of patients for the clinician.

Components of the MMSE

The MMSE is a brief 30-point questionnaire test that is used to screen for cognitive impairment. It is commonly used in medicine to screen for dementia. The test takes about 10 minutes to administer and samples various functions, including arithmetic, memory, and orientation.

Orientation

The orientation section of the MMSE assesses the patient's awareness of time and place. Questions may include asking the patient to state the current date, season, and location.

Registration

In the registration section, the examiner names three unrelated objects clearly and slowly, then asks the patient to name all three of them. The patient’s response is noted, and the examiner repeats the process until the patient learns all three objects.

Attention and Calculation

This section tests the patient's ability to concentrate and perform simple calculations. A common task is to ask the patient to subtract 7 from 100, and then continue subtracting 7 from each subsequent result.

Recall

The recall section tests the patient’s ability to remember the three objects named earlier in the registration section.

Language

The language section includes naming objects, repeating phrases, and following a three-stage command. It also involves reading and obeying a written command, writing a sentence, and copying a design.

Scoring

The MMSE is scored out of 30 points. A score of 24 or higher is considered normal, while a score below this threshold may indicate cognitive impairment. However, the MMSE is not diagnostic and should be used in conjunction with other assessments and clinical judgment.

Limitations

While the MMSE is a useful tool for screening cognitive function, it has limitations. It may not detect mild cognitive impairment and can be influenced by the patient's educational level, cultural background, and language proficiency. Additionally, it may not be sensitive to changes over time in patients with Alzheimer's disease.

Clinical Use

The MMSE is used in various settings, including hospitals, clinics, and research studies. It is often used to assess the severity of cognitive impairment at baseline and to monitor changes over time. It is also used to evaluate the effectiveness of treatment interventions.

Also see

• Cognitive assessment
• Dementia
• Alzheimer's disease
• Neuropsychological test