Mini Mental State Examinations

What is the Mini-Mental State Examination?

Marshal Folstein and colleagues developed the Mini-Mental State Examination, or MMSE, in 1975. It is a brief test that assesses cognitive impairment, such as trouble understanding, thinking, concentrating, or remembering, that can affect an individual's daily life.

An MMSE contains 11 questions that assess the following areas:

• Memorizing and recalling a list of items
• Composing short sentences with proper grammar
• Replicating a specific drawing from the examination
• Recognizing the current day, date, month, year, and season accurately
• Identifying current location

A mini-mental status examination is widely used in the healthcare industry, but clinical diagnosis shouldn't be solely based on MMSE. Instead, it should be used as a guide if an individual needs further evaluation or monitoring of cognitive deterioration. It can also be used alongside other screening tests for a more comprehensive assessment.

How to use our Mini-Mental State Examination PDF template

The mini-mental status exam can look overwhelming, so we made it easy to understand by providing an example. Here's a step-by-step guide outlining how to use this printable assessment in your clinical practice. Do take note that we

Step 1: Download the PDF

Download the Mini-Mental State Examination PDF to your device to get started. You can click on the link to download or search for the MMSE in Carepatron's template gallery.

Step 2: Brief your clients

Explain the purpose of the examination to your clients so they know what to expect.

Step 3: Conduct the examination

Practitioners can use this screening test during an online or an in-person session. It is also editable online, so you can store your clients' records digitally.

Step 4: Analyze the results

Determine the client's MMSE score. The MMSE has a maximum total score of 30, and a score less than 24 could indicate cognitive impairment.

How do you score a Mini-Mental State Examination?

The Mini-Mental State Examination is a tool designed to quickly evaluate a patient's cognitive state and  function. The test comprises a series of questions and tasks that target key cognitive domains, with each section contributing to a cumulative maximum score of 30 points.

Scoring the MMSE

The scoring process is straightforward, with specified points allotted to each component of the test:

• Orientation (10 points): This section assesses a patient's orientation to time (5 points) and place (5 points), with each correct piece of information earning a point.
• Registration (3 points): Involves the clinician stating three unrelated objects clearly and slowly, after which the patient has to repeat them back correctly to earn points.
• Attention and calculation (5 points): The patient is asked to subtract 7 from 100 continuously down to 65, with each correct subtraction earning a point. Alternatively, the patient can be asked to spell "world" backward.
• Recall (3 points): This involves remembering and correctly repeating the three unrelated objects stated in the registration section.
• Language and praxis (9 points): This section assesses multiple domains, including naming objects, following verbal and written instructions, writing a sentence spontaneously, and instructing them to copy and draw polygon shapes (1 point each).

Interpreting the score

Scores range from 0 to 30, with a higher total score indicating better cognitive function. The most commonly used cut-off for normal cognitive functioning is 24 out of 30, with lower scores suggesting cognitive impairment or possible cognitive disorders. MMSE scores are commonly interpreted as follows:

• 24-30: No cognitive impairment
• 18-23: Mild cognitive impairment
• 0-17: Severe cognitive impairment

It's important to note that MMSE scores should be interpreted in terms of the individual's age, educational level, and other factors that may influence performance. This may also be interpreted in light of results in other common cognitive tests such as the Montreal Cognitive Assessment or with their neuropsychological test performance.

When should you use a Mini-Mental State Examination?

The MMSE can be a useful tool in various clinical and research settings. Here are some common instances when it may be appropriate to administer the MMSE:

• Cognitive screening: The MMSE can be used as a routine cognitive screening measure for older adults, particularly those who are at risk of developing cognitive impairments, such as individuals with a family history of dementia or those with chronic health conditions that can affect cognition.
• Suspected cognitive impairment: If a healthcare practitioner suspects that a patient may be experiencing cognitive decline, the MMSE can provide valuable insights into the individual's cognitive functioning and help guide the diagnostic process.
• Monitoring cognitive changes: The MMSE can be used to monitor changes in a patient's cognitive function over time, particularly in individuals with known cognitive impairments, such as Alzheimer's disease or other forms of dementia.
• Pre-operative and post-operative assessment: The MMSE can be used to assess cognitive function before and after surgical procedures, which can help identify any cognitive changes that may occur as a result of the intervention.
• Differentiating between delirium and dementia: The MMSE can be a useful tool for distinguishing between delirium, an acute, reversible change in cognitive function, and dementia, a more chronic and progressive condition.

Benefits of using our free MMSE PDF template

Using this MMSE test template also offers the following benefits:

Quick screening tool

MMSE is designed to be a quick screening tool for cognitive impairment. This is why it's a widely used resource for healthcare professionals: its simplicity makes it easy to screen patients.

Standardization

MMSE provides a standardized set of questions, scoring methods, and interpretation for healthcare professionals. 

Early diagnosis

Mini-Mental State Examinations can give you a glimpse of a patient's cognitive function. If the score is low, you can use that as a starting point for further evaluation and early intervention.

Reference

Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189-198. https://doi.org/10.1016/0022-3956(75)90026-6