The document discusses the Mini-Mental State Examination (MMSE), a 30-point questionnaire used to screen for cognitive impairment. It describes the origins of the MMSE and outlines its purpose to test orientation, attention, memory, language, and visual-spatial skills. The summary also explains that the MMSE takes 10-15 minutes to administer and provides measures in several categories including orientation, registration, attention, recall, and language. Scores are interpreted on a scale of 0-30, with higher scores indicating better cognitive functioning.

1. Mrs.D.Melba Sahaya Sweety.D
Msc.Nursing
GIMSAR

2. INTRODUCTION
The Mini–Mental State Examination (MMSE) or Folstein test is
a 30-point questionnaire that is used extensively in clinical
and research settings to measure cognitive impairment, It
was developed by Dr. Marshall Folstein in the year of 1975
The Mini-Mental State Exam (MMSE) is a widely used test of
cognitive function among the elderly; it includes tests of
orientation, attention, memory, language and visual-spatial
skills.
The mini-mental state examination is proprietary and takes
about 10-15 minutes to administer.

3. DEFINITION
The Mini-Mental status
Examination is a cognitive
test to screen for the
presence of cognitive
impairment example
Dementia

4. • It is useful in helping differentiate
between a variety of systemic
conditions, as well as neurologic
and psychiatric disorders ranging
from delirium and dementia to
bipolar disorder and
schizophrenia.
PURPOSE OF MMSE

5.  It provides measures of
orientation,registration & short-term
memory,attention, voluntary
movement &language functioning.
 The shortened version of the mini
mental state examination is an
accurate predictor of dementia.
 It has also been recommended for the
screening of cognition
in depressed patients
PURPOSE OF MMSE

6. GUIDELINES OF ADMINISTERING
MMSE
• Try to get the person to sit down facing you.
• Assess the person’s ability to hear and understand very simple
conversation, e.g. what is your name? if the person uses hearing
or visual aids, provide these before starting.
• Introduce yourself and try to get the person’s confidence.
• Before you begin, get the person’s permission to ask questions,
e.g. would it be all right to ask you some questions about your
memory? this helps to avoid catastrophic reactions.
• Ask each question a maximum of three times.

7. GUIDELINES OF ADMINISTERING
MMSE
• If the person answers incorrectly , give score zero.
• Accept that answer and do not ask the question again
• Hint, or provide any physical clues such as head shaking,
etc.
• If the person answers what did you say?, do not explain or
engage in conversation, merely repeat.
• If the person interrupts (e.g. queries what is this for?), just
reply: I will explain in a few minutes, when we are finished.
now if we could proceed please, we are almost finished

8. CATEGORIES OF MMSE
Appearance
Orientation
Registration
Attention
Calculation
Recall
Language

9. CATEGORIES OF
MMSE
 Look the age of the patient.
 Observe the physical features of the
patient that are associated with certain
conditions, such as the almond-shaped
eyes associated with Down syndrome.
 Check the grooming level of the patient
 Whether the patient is dressed
appropriately for the situation and the
weather.
APPEARANCE

10. • Monitor how comfortable the patient are
in social situations.
• Observe the body language of the patient.
• The examiner will look for movements
that are characteristic of certain conditions,
such as excessive movement or muscle
contractions.
• Observe how the patient make eye
contact, for instance notice whether the
patient stare intensely or avoid eye
contact altogether.
CATEGORIES OF
MMSE APPEARANCE

11. ORIENTATION
• Temporal Orientation
• Which year is this?
• What Season it is ?
• What is today’s date?
• What is the Day of the week?
• Which Month is this?
• Geographical Orientation
• Where are we now?
• Which State we live in?
• What is the name of this County ?
• What is the name of your Town?
• What is the name of this city?
• What is the name of this Hospital ?
• What Floor are we on?
CATEGORIES OF
MMSE
Can orient patient if they missed an item-
ask the same question again at the end of
the session – did they remember ?
Maximum score is 5 for each orientation

12. • The examiner names three unrelated
objects clearly and slowly, then the
instructor asks the patient to name all
three of them. The patient’s response is
used for scoring. The examiner repeats
them until patient learns all of them, if
possible. [Example Examiner names 3
objects (eg apple, table, car) Patient
asked to repeat (1 point for each
correct)].
• Maximum score is 3
CATEGORIES OF
MMSE
REGISTRATION

13. • “I would like you to count backward
Subtract 7 from 100, then repeat
from result.
• Continue 5 times: 100 93 86 79 65
• Alternative: “Spell WORLD
backwards.” (D-L-R-O-W)
• Maximum score is 5
CATEGORIES OF
MMSE
ATTENTION AND CALCULATION

14. • Earlier I told you the
names of three things.
Can you tell me what
those were?”
• Maximum score is 3
CATEGORIES OF
MMSE
RECALL

15. • Naming: Show the patient two simple objects, such as a
wristwatch and a pencil, and ask the patient to name
them. 1 point for each Maximum score is 2
• Repetition: Ask the person to repeat the following. No
„ifs‟ & or „buts‟ (1point). Allow only one trial Maximum
score is 1
• Command: Give a 3 stage command. Score 1 for each
stage. Eg. "Place index finger of right hand on your nose
and then on your left ear". Maximum score is 3
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CATEGORIES OF
MMSE

16. Reading: Write „CLOSE YOUR EYES‟ in large letters &
show it to the patient. Ask him or her to read the message &
do what it says (give 1 point if they actually close their
eyes).Score is 1
Writing: Ask the individual to write a sentence of their
choice on a blank piece of paper. The sentence must contain a
subject & a verb, & must make sense. Spelling punctuations
& grammar are not important Maximum score is 1
Copying :Ask the patient to copy a pair of intersecting
pentagons:. Maximum score is 1
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CATEGORIES OF
MMSE

17. • The Mini-mental state examination is scored on a
scale of 0-30 with scores > 25 interpreted as
normal cognitive status.
• Severe cognitive impairment: ≤9
• Moderate cognitive impairment :10-18
• Mild cognitive impairment: 19-23
• No cognitive impairment: 24-30
• Interpretation of the mental status examination
must take into account the patient's native
language, education level, and culture as these
factors can affect performance.[
SCORING AND
INTERPERTATION OF MMSE

18. Relatively quick and easy to
perform
Requires no additional
equipment
Can provide a method of
monitoring deterioration
over time
ADVANTAGES OF MMSE

19. – Biased against people with poor
education due to elements of
language and mathematical testing
– Bias against visually impaired
– Limited examination of visuospatial
cognitive ability
– Poor sensitivity at detected
mild/early dementia
DISADVANTAGES OF
MMSE

20. – Copyrighted and should the most
up to date version should
officially only be accessed via the
Psychological Assessment
Resourcing (PAR)
– Patients new to a region may not
geographic orientation aspect of
the test
– False positives can lead to
anxiety ,labelling and stigma
DISADVANTAGES OF
MMSE