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
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, language use and comprehension, and copying a drawing.

Interpretation
Any score over 24 (out of 30) 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.

Enforcement of the MMSE copyright
With the significant popularity of the test, the current copyright owner (Psychological Assessment Resources (PAR)) has decided to enforce the copyright and set-up a website to sell official versions of the test. This is the reason why the full MMSE cannot be presented on Wikipedia.

The enforcement of the copyright on the MMSE has been compared to stealth patents, where a patent holder waits until an invention gains widespread popularity until commencing enforcement, and is thought to have subsequently impeded research in the assessment of cognitive function.

The enforcement of the MMSE copyright has led to a backlash that bears some resemblance to the one associated with Unisys' enforcement of a patent essential for the creation of gif images and has led to more discussion about open access and open content journals.