Mini-Mental State Examination (MMSE)
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A Mini-Mental State Examination (MMSE) is a cognitive impairment test.
- Context:
- It can (typically) be a 30-Point Questionnaire that ...
- …
- Example(s):
- Counter-Example(s):
- See: Delirium, Medicine, Dementia, Nosology, Recollection, Language, Orientation (Mental), Mental Status Examination, Alzheimer's Disease, Abbreviated Mental Test Score, General Practitioner Assessment of Cognition.
References
2022
- (Wikipedia, 2022) ⇒ https://en.wikipedia.org/wiki/Mini–Mental_State_Examination Retrieved:2022-12-30.
- 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 is commonly used in medicine and allied health to screen for dementia. It is also used to estimate the severity and progression of cognitive impairment and to follow the course of cognitive changes in an individual over time; thus making it an effective way to document an individual's response to treatment. The MMSE's purpose has been not, on its own, to provide a diagnosis for any particular nosological entity. Administration of the test takes between 5 and 10 minutes and examines functions including registration (repeating named prompts), attention and calculation, recall, language, ability to follow simple commands and orientation. It was originally introduced by Folstein et al. in 1975, in order to differentiate organic from functional psychiatric patients but is very similar to, or even directly incorporates, tests which were in use previous to its publication. This test is not a mental status examination. The standard MMSE form which is currently published by Psychological Assessment Resources is based on its original 1975 conceptualization, with minor subsequent modifications by the authors. Advantages to the MMSE include requiring no specialized equipment or training for administration, and has both validity and reliability for the diagnosis and longitudinal assessment of Alzheimer's disease. Due to its short administration period and ease of use, it is useful for cognitive assessment in the clinician's office space or at the bedside. Disadvantages to the utilization of the MMSE is that it is affected by demographic factors; age and education exert the greatest effect. The most frequently noted disadvantage of the MMSE relates to its lack of sensitivity to mild cognitive impairment and its failure to adequately discriminate patients with mild Alzheimer's disease from normal patients. The MMSE has also received criticism regarding its insensitivity to progressive changes occurring with severe Alzheimer's disease. The content of the MMSE is highly verbal, lacking sufficient items to adequately measure visuospatial and/or constructional praxis. Hence, its utility in detecting impairment caused by focal lesions is uncertain. Other tests are also used, such as the Hodkinson Abbreviated Mental Test score (1972), Geriatric Mental State Examination (GMS), or the General Practitioner Assessment of Cognition, bedside tests such as the 4AT (which also assesses for delirium), and computerised tests such as CoPs [1] and Mental Attributes Profiling System, [2] as well as longer formal tests for deeper analysis of specific deficits.
2022
- (Wikipedia, 2022) ⇒ https://en.wikipedia.org/wiki/Mini%E2%80%93Mental_State_Examination#Test_features Retrieved:2022-12-30.
- The MMSE test includes simple questions and problems in a number of areas: the time and place of the test, repeating lists of words, arithmetic such as the serial sevens, language use and comprehension, and basic motor skills. For example, one question, derived from the older Bender-Gestalt Test, asks to copy a drawing of two pentagons (shown on the right or above).
A version of the MMSE questionnaire can be found on the British Columbia Ministry of Health website.[1]
Although consistent application of identical questions increases the reliability of comparisons made using the scale, the test can be customized (for example, for use on patients that are blind or partially immobilized.) Also, some have questioned the use of the test on the deaf.[2] However, the number of points assigned per category is usually consistent:
- The MMSE test includes simple questions and problems in a number of areas: the time and place of the test, repeating lists of words, arithmetic such as the serial sevens, language use and comprehension, and basic motor skills. For example, one question, derived from the older Bender-Gestalt Test, asks to copy a drawing of two pentagons (shown on the right or above).
| Category | Possible points | Description |
|---|---|---|
| Orientation to time | 5 | From broadest to most narrow. Orientation to time has been correlated with future decline.[3] |
| Orientation to place | 5 | From broadest to most narrow. This is sometimes narrowed down to streets,[4] and sometimes to floor.[5] |
| Registration | 3 | Repeating named prompts |
| Attention and calculation | 5 | Serial sevens, or spelling "world" backwards.[6] It has been suggested that serial sevens may be more appropriate in a population where English is not the first language.[7] |
| Recall | 3 | Registration recall |
| Language | 2 | Naming a pencil and a watch |
| Repetition | 1 | Speaking back a phrase |
| Complex commands | 6 | Varies. Can involve drawing figure shown. |
- ↑ "British Columbia Ministry of Health Standard MMSE (PDF)". http://www.health.gov.bc.ca/pharmacare/adti/clinician/pdf/ADTI%20SMMSE-GDS%20Reference%20Card.pdf.
- ↑ Dean, PM; Feldman, DM; Morere, D; Morton, D (December 2009). "Clinical evaluation of the mini-mental status exam with culturally Deaf senior citizens". Arch Clin Neuropsychol 24 (8): 753–60. doi:10.1093/arclin/acp077. PMID 19861331.
- ↑ "The MMSE orientation for time domain is a strong predictor of subsequent cognitive decline in the elderly". Int J Geriatr Psychiatry 24 (12): 1429–37. December 2009. doi:10.1002/gps.2282. PMC 2919210. PMID 19382130. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2919210.
- ↑ Morales LS, Flowers C, Gutierrez P, Kleinman M, Teresi JA; Flowers; Gutierrez; Kleinman; Teresi (November 2006). "Item and scale differential functioning of the Mini-Mental Status Exam assessed using the Differential Item and Test Functioning (DFIT) Framework". Medical Care 44 (11 Suppl 3): S143–51. doi:10.1097/01.mlr.0000245141.70946.29. PMC 1661831. PMID 17060821. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1661831.
- ↑ "MMSE". http://www.utmb.edu/psychology/ClinPsych/MiniMental.htm. Retrieved 2009-12-10.
- ↑ "Serial sevens versus world backwards: a comparison of the two measures of attention from the MMSE". J Geriatr Psychiatry Neurol 3 (4): 203–7. 1990. doi:10.1177/089198879000300405. PMID 2073308.
- ↑ Espino DV, Lichtenstein MJ, Palmer RF, Hazuda HP; Lichtenstein; Palmer; Hazuda (May 2004). "Evaluation of the mini-mental status examination's internal consistency in a community-based sample of Mexican-American and European-American elders: results from the San Antonio Longitudinal Study of Aging". Journal of the American Geriatrics Society 52 (5): 822–7. doi:10.1111/j.1532-5415.2004.52226.x. PMID 15086669.