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What is a Mini Mental State Examination (MMSE)?
The Mini Mental State Examination (MMSE) is also known as the Folstein test. It is a short test of 30 questions that is used to screen for memory problems or identify dementia symptoms. This is a test that health care practitioners use to determine the level of cognitive impairment. This is a test that can detect early symptoms and the following cognitive changes in a person over a period of time. It is considered to be an effective tool to determine an individual’s cognitive changes as well as response to treatment. It is not a test to determine mental status.
The Mini Mental State Examination (MMSE) was originally developed in 1975 as an appendix to an article written by Marshall and Susan Folstein and is now published by the Psychological Assessment resources.
This test takes about 10 to 15 minutes and assesses an individual’s memory, orientation, math skills and ability to concentrate. The MMSE test utilizes easy questions that address a number of different areas: the time and place, repeating a list of words, math problems such as the counting by sevens, understanding and language use and the ability to recall. The test also assesses basic motor skills.
The test has a 30-point rating system. Scores of 25 points and higher are considered within normal range. Scores of points between 10 and 19 are considered to be indicative of moderate stages of dementia. Anyone scoring less than 10 points is generally has severe cognitive impairment.
It is important for the layperson to know that while these tests are guidelines, they are not inconclusive as to determining dementia. There are many other factors that the health care professional must take into account when determining the score.
For example, there are some individuals that have a higher level of education and achieve a very high score, but have significant cognitive deficits. So an individual’s level of education must be taken into consideration. The test score may also decline with advancing age.
The health care provider administering the test must consider not only an individual’s age, but also the race, ethnicity and education level of the person that is being tested.
It is important to have a comprehensive battery of tests, such as scans, complete physical and medical examination, as well as a complete medical history to determine a diagnosis of dementia.
The benefits if the mini mental (MMSE) is that it is a simple, easy test to administer and is now widely recognized as a validated screening tool. It is also a great tool for health care professionals to utilize the progression of the disease process in an individual and their response to treatment.
The MMSE has been translated into many different languages and even adapted for those with visual impairments. It has become a worldwide standard screening tool.
There are disadvantages to the test. If an individual is unable to read or write, experienced a stroke and is having difficulty communicating, this is not an effective tool. The MMSE relies heavily on an individual’s ability to verbally and physically respond. Those individuals that have difficulty seeing, or physically responding can affect the results of the test.
Recent research has found that the MMSE is an inadequate screening tool to identify early stages of dementia, or mild cognitive impairment. Identifying the early stages of dementia is key to introducing treatment and delaying the course of the condition.
It is important that family members be aware that they may be able to identify cognitive deficits and behavior problems of early dementia and the MMSE may not identify that there is a problem. This is a time when the family member should discuss with the health care provider that more testing should be considered. Early identification and treatment is important. Do not hesitate to ask your health care provider to utilize other screening tools that may identify the early stages of dementia.