MINI MENTAL STATE EXAMINATION(MMSE)

BY DR ZAINAB ABDULZAEEZ UMARDEPARTMENT OF FAMILY

MEDICINEAMINU KANO TEACHING

HOSPITAL

SYNOPSISINTRODUCTIONPREPARATIONPROCESSSCORINGINTERPRETATIONCONCLUSIONDEMOSTRATION

INTRODUCTIONThe MMSE was developed in 1975 by M

Folstein et al as a screening tool to test cognitive function of older people

The Mini Mental State Examination (MMSE) is the most commonly used test for complaints of memory problems. It can be used by clinicians to help diagnose dementia and to help assess its progression and severity

(MMSE) or Folstein test is a sensitive, valid and reliable 30-point questionnaire that is used extensively in clinical and research settings to measure cognitive impairment.

Administration of the test takes between 5–10 minutes and examines functions including registration,attention and calculation, recall,language, ability to follow simple commands and orientation

PREPARATIONBefore administering the MMSE it is

important to make the patient comfortable

Establish rapport with the patient.

Materials needed

processGeneral guidelineRecord name and date the test is

performedRecord response for each questionAsk each question maximum of

10secsDo not hint , prompt for an answer

or provide physical clues.

SCORING MMSEOrientation 10Registration 3Attention and calculation 5Recall 3Language

o Naming 2o Repetition 1o Comprehension 3o Reading 1o Writing 1o Visuo-spatial task 1

Orientation in Time (5)

What year is this?What season?What month?What day of the week?What date?

Orientation to Place (5)What country are we now?What state are we in?What Local Government Area is

this?What city/area is this?What floor are we on? (or what

ward/room are we in?)

Registration (3)Listen carefully. I’m going to say 3 words.

You say them back after I stop. Ready?CAR MANGO BOOK

Now repeat those words back to meNow keep those words in mind. I’m going to

ask you to say them again in a few minutes

Attention and Calculation (5)

Serial 7’s: I’d like you to subtract 7 from 100. Then keep subtracting 7 from each answer until I tell you to stop. What is 100 take away (minus) 7?….Keep going

OR: Spell “WORLD” forward, then backward

Recall (3)

What were those words I asked you to remember?

No hints

Naming objects (2)

Tests ability to recognize and name 2 common objects- ex. Biro, Watch, tie

Point to a Biro and a watch. Have the patient name them as you

point.(2 points)

Repetition (1)

Now I am going to ask you to repeat what I say…Ready?

Have the patient repeat the phrase “No ifs, ands, or buts”

Comprehension (3)

Have the Patient follow a 3-stage command:

Take the paper in your right hand

Fold the paper in half

Put the paper on the floor

Reading (1)

Please read this and do what it says:“CLOSE YOUR EYES” (write it in

large letters)

Writing (1)

Please write a sentence of your choice

Point given if sentence is comprehensible and contains a subject and verb

Ignore spelling errors when scoring

Drawing/Visuospatial Task (1)Please copy this design

•Give one point if all sides and angles are preserved and if the intersecting sides form a quadrangle

Interpreting the Score27-30: normal21-26: mild cognitive impairment11-20: moderate cognitive impairment0-10: severeVaries with age, education, population

Limitation of MMSEResults are dependent onAge Language skillsEducational levelSensory deficit(hearing and vision)Motor deficit(tremors, paralysis)Does not test all areas of cognition(eg frontal

lobe)

conclusionMMSE is a well established, fast and reliable

way of gauging cognitive functioning

The process of undertaking MMSE can identify health issues and provide information useful for planning care

DEMOSTRATION

Ensure that hearing or visual aids are available with adequate lighting and ventilation

Praising success may help to maintain the rapport and is acceptable. However, persisting on items the patient finds difficult should be avoided