The Mini-Mental State Examination (MMSE) is a widely used tool for assessing cognitive function and screening for cognitive impairment, including dementia. It’s a brief, structured test that evaluates various aspects of cognitive abilities. The MMSE is composed of a series of questions and tasks grouped into several sections, each testing different cognitive domains:
- Orientation (10 points):
- The patient is asked to state the date (day, month, year), day of the week, and season. They are also asked to identify the place they are in (country, state/region, town, hospital or facility, and floor).
- Registration (3 points):
- The examiner names three unrelated objects (commonly items like “apple, penny, table”) and the patient is asked to repeat them immediately to test immediate recall.
- Attention and Calculation (5 points):
- The patient is asked to perform a serial subtraction task, commonly subtracting 7 from 100 sequentially five times (100, 93, 86, 79, etc.). Alternatively, the patient may be asked to spell a word like WORLD backwards.
- Recall (3 points):
- The patient is asked to recall the three objects named earlier in the registration section.
- Language (9 points):
- This part includes several tasks:
- Naming: The patient is asked to name two simple objects, like a pencil and a watch.
- Repetition: The patient is asked to repeat a simple phrase.
- 3-Stage Command: The patient is asked to take a paper in their right hand, fold it in half, and put it on the floor.
- Reading: The patient is asked to read and obey a written command, such as “Close your eyes.”
- Writing: The patient is asked to write a sentence.
- Visual-Spatial Ability (1 point):
- Copying: The patient is asked to copy a simple design (such as intersecting pentagons).
The total score of the MMSE ranges from 0 to 30, with higher scores indicating better cognitive function. A score of 24 or higher generally suggests normal cognition, while lower scores indicate possible impairment. The cutoff points can vary based on the patient’s age and education level.
The MMSE is quick to administer, taking about 5-10 minutes, and is useful in both clinical settings and research. However, it is not a diagnostic tool by itself but rather a screening instrument that helps identify individuals who may require more comprehensive neuropsychological testing. It’s also used to monitor changes in cognitive abilities over time.