Bsc,3,Rd Year

1. MINI MENTAL STATUS
EXAM
<UNDER GUIDANCE> <PRESENTED BY>
MR.NEERAJ VERMA PARUL YADAV
FACULTY OF NURSING BSC NURSING 3RD YEAR

2. INTRODUCTION
• IT IS DEVELOPED BY DR. MARSHALL FOLSTEIN IN 1975,
MMSE/FOLSTEIN TEST WIDELY USED FOR MEASURE
COGNITIVE IMPAIRMENT IN OLDER ADULTS.
• 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
.

3. (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

4. OBJECTIVES
• To determine the accuracy of the Mini Mental State Examination for
the early detection of dementia in people with mild cognitive
impairment
• AIM : The mini - mental state examination is to determine.
• level of counsciousness.
• Attention
• concentration
• Orientation to person, time, place
• Short term Memory
• Language

5. • mini mental state examination (MMSE) is a
commonly used set of questions for screening
cognitive function. This examination is not suitable
for making a diagnosis , but can be used to
indicate the presence of cognitiveimpairment,
such as in a person with suspected
• Dementia
• Delirium
• Parkinson`s
• head injury.
INDICATIONS

6. SCORING MMSE
• Orientation (10)
• Registration (3)
• Attention and calculation (5)
• Recall (3)
• Language
 Naming (2)
 Repetition (1)
 Comprehension (3)
 Reading (1)
 Writing (1)
 Visuo-spatial task (1)

7. LIMITATIONS OF MMSE
Results are dependent on
• language skills.
• Education level .
• Sensory deficit ( hearing & visual ).
• Motor deficit ( tremors , paralysis).
• Doesn`t test all areas of cognitive functioning (e.g. frontal lobe).

8. COMPONENTS OF MMSE
Orientation
 Calculation
 Registration
 Recall
 Attention
 Language

9. TEMPOARAL ORIENTATION
what year is this ?
What seasons is this ?
What month ?
What day of this week ?
What date ?
ORIENTATION

10. • GEOGRAPHICAL ORIENTATION
• Where are we now ?
• Which floor are we in this hospital ?
• Which state we are in ?
• Which country is this ?
• Which city is this ?
ORIENTATION

11. • Make sure participant is attentive when beginning the question.
• Listen carefully, I’m going to say 3 words. you say them back after I stop.
• Read the words slowly. APPLE…… ,TABLE…… , PEN…...
• If participant asks you to repeat the 3 items, Respond, Can you tell me the items ANY ONE OF
THEM ?
If participant say NO ,THEN Read; Apple, Table, Penny.
• Record the score for the first trial.
• If, after scoring the first attempt, the participant has not learned
3 objects, repeat the list of objects up to 6 times until he/she has
learned them.
REGISTRATION

12. • By pointing to a pencil & clock ask the patient to name the object.
• Enunciate clearly - include the "S" at the end of ands, or but& (if you think the
participant heard you but repeated it incorrectly, make a note of what was missed
and score 0).
• Give three stage command. Score 1 for each stage . Place index finger of right hand
on your nose and then on your left .
• Tell patient to read and obey a written command on a piece of paper “CLOSE YOUR
EYES”
• Give a sheet of paper tell patient to write a meaningful sentence.
LANGUAGE

14. • To Assess the recalling ability of the
patient
• Ask the patient to recall the three
object which I told to you before.
• If patient is able to recall give one
point for each correct answer
RECALL

15. • Now I am going to spell a word forward and I want
you to spell it backwards. The word is
WORLD……… W-0-R-L-D Please spell it in
reverse order.
• Ask patient to subtract 7`s from 100 & continue it 5
times : 100,93,86,79,65
ATTENTION & CALCULATION

19. • MMSE is interpreted in the following way :
• 27 – 30 : normal
• 21 to 26 :- mild cognitive impairment
• 11 -20 : -- moderate cognitive impairment
• 0 – 10 : -- severe cognitive impairment
SCORE

20. • Before administer exam.
• Ensure that at least 12 hrs have elapsed since the last ingestion of
drug/alcohol.
• Patient must be instructed that ingestion of even smallest amount of alcohol
such as cough syrup, drops of any kind drug brings unpleasent effects
• If client is verbally upset listen carefully , give support change the topic
• Assist the client as needed to maintain the daily function and adequate
personal hygiene.
ROLE OF NURSE

21. • Greet ,introduce yourself ,confirm the patient .
• An informed consent should be taken before starting
exam
• Take a good history and examination .
• Always include care givers .
• It is advisable to family members before MMSE
screening
(this can be done with the help of the assistant)
ADMINISTERING THE MMSE

22. • Explain the result to the patient
• Answer patients questions and clarify issues that are confusing
• Thanks patient after test ,continue with other investigations ,
conduct other more sensitive tests , refer if indicated and give
appointment for follow up
CONTI……

23. ‘’WHAT MIND DOES NOT KNOW EYE DOES NOT
SEE’’