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CLOGNITION |
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CLOGNITION |
The Mini Mental State Examination (MMSE) is a widely used method
for assessing cognitive mental status. The evaluation of cognitive functioning
is important in clinical settings because of the recognized high prevalence of
cognitive impairment in medical patients. As a clinical instrument, the MMSE has
been used to detect impairment, follow the course of an illness, and monitor
response to treatment. The MMSE has also been used as a research tool to screen
for cognitive disorders in epidemiological studies and follow cognitive changes
in clinical trials.
While the MMSE has limited specificity with respect to individual clinical syndromes, it represents a brief, standardized method by which to grade cognitive mental status. It assesses orientation, attention, immediate and short-term recall, language, and the ability to follow simple verbal and written commands. Furthermore, it provides a total score that places the individual on a scale of cognitive function.
The normative data for different ages and educational levels are presented below, as is a list of references on the use of the MMSE. Further information on the MMSE may be obtained at www.minimental.com, or by contacting Dr. Marshal F. Folstein.
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Folstein Mini Mental Status
Examination |
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Task |
Instructions |
Scoring |
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Date Orientation |
"Tell me the
date?" Ask for omitted items. |
One point each for
year, season, date, day of week, and month |
5 |
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Place Orientation |
"Where are you?"
Ask for omitted items. |
One point each for
state, county, town, building, and floor or room |
5 |
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Register 3 Objects |
Name three objects
slowly and clearly. Ask the patient to repeat them. |
One point for each
item correctly repeated |
3 |
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Serial Sevens |
Ask the patient to
count backwards from 100 by 7. Stop after five answers. (Or ask them to
spell "world" backwards.) |
One point for each
correct answer (or letter) |
5 |
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Recall 3 Objects |
Ask the patient to
recall the objects mentioned above. |
One point for each
item correctly remembered |
3 |
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Naming |
Point to your
watch and ask the patient "what is this?" Repeat with a pencil. |
One point for each
correct answer |
2 |
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Repeating a Phrase |
Ask the patient to
say "no ifs, ands, or buts." |
One point if
successful on first try |
1 |
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Verbal Commands |
Give the patient a
plain piece of paper and say "Take this paper in your right hand, fold it
in half, and put it on the floor." |
One point for each
correct action |
3 |
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Written Commands |
Show the patient a
piece of paper with "CLOSE YOUR EYES" printed on it. |
One point if the
patient's eyes close |
1 |
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Writing |
Ask the patient to
write a sentence. |
One point if
sentence has a subject, a verb, and makes sense |
1 |
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Drawing |
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One point if the
figure has ten corners and two intersecting lines |
1 |
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Scoring |
A score of 24 or above is considered
normal. |
30 |
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Adapted
from Folstein et al, Mini Mental State, J PSYCH RES 12:196-198 (1975) |
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Ask the
patient to copy a pair of intersecting pentagons onto a piece of paper.