Mini mental state examination

The mini mental state examination (MMSE) or Folstein test is a brief 30-point questionnaire test that is used to assess cognition. It is commonly used in medicine to screen for dementia. In the time span of about 10 minutes, it samples various functions, including arithmetic, memory and orientation. It was introduced by Folstein et al in 1975, and is widely used with small modifications.

Various other tests are also used, such as the Hodkinson abbreviated mental test score (1972, geriatrics) and longer formal tests for deeper analysis of specific deficits.

The test
A summary of the MMSE test:
 * Orientation in time: what is the year, month, date, season, day of the week?(1 point each, total 5)
 * Orientation in place: in which state, county, town/city, hospital/street, floor/number are you now? (1 point each, total 5)
 * Registration: repeat these three words - e.g. car, ball, key (1 point for each, total 3)
 * Arithmetic: "serial sevens" -- take 100 and subtract 7 in 5 iterations - 100, 93, 86, 79, 72, 65 (1 point for each, total 5)
 * Recall/memory: repeat the three words from before (1 point each, total 3)
 * Language: (total 8)
 * name these objects - e.g. key, watch (1 point for each, maximum 2).
 * repeat "NO IFS, ANDS OR BUTS" (1 point for correctly repeating)
 * follow a three-stage instruction - take this sheet of paper, fold it over once, and put it on your lap (1 point each, total 3)
 * read and obey "CLOSE YOUR EYES" (1 point for closing eyes)
 * write a sentence (1 point for a grammatically correct sentence)
 * Spatial insight: copy out a drawing of two interlocking pentagons (1 point for correct drawing)

Interpretation
Any score over 24 is effectively normal. The normal value is also corrected for degree of schooling and age. Low to very low scores correlate closely with the presence of dementia, although other mental disorders can also lead to abnormal findings on MMSE testing. The presence of purely physical problems can also interfere with interpretation if not properly noted; for example, a patient may be physically unable to hear or read instructions properly, or may have a motor deficit that affects writing and drawing skills.

Reference

 * Folstein M, Folstein S, McHugh P. Mini-Mental State. A practical method for grading the cognitive state of patients for the clinician. J Psych Res 1975;12:189&#8211;198. PMID 1202204.
 * Hodkinson HM. Evaluation of a mental test score for assessment of mental impairment in the elderly. Age Ageing 1972;1:233-8. PMID 4669880.