Posted by: Thixia | April 3, 2008

Mini-Mental Status Examination (MMSE)

 

The Folstein Mini-Mental Status Examination (MMSE)

The MMSE is a tool for screening cognitive decline associated with Multiple Sclerosis (Folstein et al. 1975).

  • Questions 1 through 10 screen orientation in time and place.
  • Questions 11 to 13 screen learning and immediate recall.
  • Questions 14 to 18 screen mental control and concentration.
  • Questions 19 to 21 screen short-term recall.
  • Questions 22 and 23 screen naming ability.
  • Question 24 is an item to screen language expression.
  • Question’s 25 to 27 screen verbal comprehension.
  • Question 28 is an item to screen writing comprehension.
  • Questions 29 & 30 screen writing ability and visuo-spatial coordination.

In addition to the MMSE, practioners often measure executive abilities with a Clock Drawing Test and/or an Alternating Figures Test though these are not part of the standardized procedure.

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Question

Correct Answer

Incorrect Answer

1. What year is it?

2. What season are we in?

3. What month are we in?

4. What is todays date?

5. What day of the week is it?

6. What country are we in?

7. What province are we in?

8. What city are we in?

9. What street are we on (What building? if in hospital or clinic)

10. What is the street number? (What floor? – if in hospital or clinic)


Name three objects (“Ball”, “Car”, “Man”). Take a second to pronounce each word. Then ask the patient to repeat all 3 words. Take into account only correct answers given on the first try. Repeat these steps until the subject learns all the words.
11. Ball?

12. Car?

13. Man?


Either “please spell the word WORLD and now spell it backwards” or “Please count from 100 by subtracting 7 every time”.
14. “D” or 93

15. “L” or 86

16. “R” or 79

17. “O” or 72

18. “W” or 65


What were the 3 words I asked you to remember earlier?
19. Ball?

20. Car?

21. Man?


Show the subject a pen and ask:
22. Could you please name this object?


Show the subject your watch and ask:
23. Could you please name this object?


Listen and repeat after me: 
24. “No ifs, ands or buts.”


Put a sheet of paper on the desk and show it while saying: “Listen carefully and do as I say.”
25. Take the sheet with your left/right (opposite to dominant)hand.

26. Fold it in half.

27. Put it on the floor.


Show the patient the Visual Instruction Page directing him/her to “CLOSE YOUR EYES” and say:
28. Do what is written on this page.


Give the subject a blank sheet and a pen and ask: 
29. Write a sentence, whatever you want, but a complete sentence. 


Give the patient the geometric design page and ask:
30. Could you please copy this drawing?


TOTAL               

A score of over 25 may be normal while a score below 20 is indicative of dementia. When your client scores between 20 and 30 he/she should be re-evaluated 2 months later.

 If your client scores in the normal range but his/her family report declining behavioural integrity and cognitive problems, consider more detailed assessment by a geriatric psychologist or behavioural neurologist.

 Test scores should always be interpreted cautiously and this is especially in the context of socio-cultural diversity or developmental disability.

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