Mini-Mental State Examination

A test used to screen for dementia and to estimate it’s severity and the progression of cognitive impairment over time.

It includes 30 questions and examines linguistic, computational, memory, concentration, and orientation functions.

For the visually impaired eight items are omitted that require vision.

A 30-point questionnaire that is used extensively in clinical and research settings to measure cognitive impairment.

It is commonly used to screen for dementia.

It is used to estimate the severity and progression of cognitive impairment and to follow the course of cognitive changes in an individual over time.

It does not provide a diagnosis for any particular nosological entity.

The test takes between 5 and 10 minutes.

The examines functions including registration, attention and calculation, recall, language, ability to follow commands and orientation.

It is not a mental status examination.

It is useful for cognitive assessment in the clinician’s office or at the bedside.

It is affected by factors such as age and education.

It lacks of sensitivity to mild cognitive impairment

It fails to discriminate patients with mild Alzheimer’s disease from normal patients, and is insensitive to progressive changes occurring with severe disease.

Its utility in detecting impairment caused by focal CNS lesions, is uncertain.

Any score greater than or equal to 24 points out of 30 indicates a normal cognition.

Scores indicating severe (≤9 points), moderate (10–18 points) or mild (19–23 points) cognitive impairments.

The score may also need to be corrected for educational attainment and age.

Low to very low scores correlate closely with the presence of dementia.

Mental disorders can also lead to abnormal findings on MMSE testing.

Physical problems with hearing or reading or with have a motor deficit that affects writing and drawing skills may affect scores.

Is able to differentiate different types of dementias: patients with Alzheimer’s disease score significantly lower on orientation to time and place, and recall compared to patients with dementia with Lewy bodies, vascular dementia and Parkinson’s disease dementia.

No evidence to support it as a stand-alone one-time test for identifying high risk individuals who are likely to develop Alzheimer’s.

The test should be used as a screening device for cognitive impairment or a diagnostic adjunct in which a low score indicates the need for further evaluation.

It should not serve as the sole criterion for diagnosing dementia.

It is not intended to differentiate between various forms of dementia.

Scores may be used to classify the severity of cognitive impairment or to document serial change in dementia patients.


no cognitive impairment=24-30

mild cognitive impairment=18-23

severe cognitive impairment=0-17

Patients undergoing the testing should have at least a grade eight education and be fluent in English.

Low educational levels increase the likelihood of misclassifying normal subjects as cognitively impaired

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