Exam

Mini-Mental State Examination (MMSE)

Patient’s Name: Date:

Instructions: Score one point for each correct response within each question or activity.

Maximum Score

Patient’s Score

Questions

5 “What is the year? Season? Date? Day? Month?”

5 “Where are we now? State? County? Town/city? Hospital? Floor?”

3

The examiner names three unrelated objects clearly and slowly, then the instructor asks the patient to name all three of them. The patient’s response is used for scoring. The examiner repeats them until patient learns all of them, if possible.

5 “I would like you to count backward from 100 by sevens.” (93, 86, 79, 72, 65, …) Alternative: “Spell WORLD backwards.” (D-L-R-O-W)

3 “Earlier I told you the names of three things. Can you tell me what those were?”

2 Show the patient two simple objects, such as a wristwatch and a pencil, and ask the patient to name them.

1 “Repeat the phrase: ‘No ifs, ands, or buts.’”

3 “Take the paper in your right hand, fold it in half, and put it on the floor.” (The examiner gives the patient a piece of blank paper.)

1 “Please read this and do what it says.” (Written instruction is “Close your eyes.”)

1 “Make up and write a sentence about anything.” (This sentence must contain a noun and a verb.)

1

“Please copy this picture.” (The examiner gives the patient a blank piece of paper and asks him/her to draw the symbol below. All 10 angles must be present and two must intersect.)

30 TOTAL

Interpretation of the MMSE:

Method Score Interpretation

Single Cutoff <24 Abnormal

Range <21

>25

Increased odds of dementia

Decreased odds of dementia

Education

21

<23

<24

Abnormal for 8th grade education

Abnormal for high school education

Abnormal for college education

Severity

24-30

18-23

0-17

No cognitive impairment

Mild cognitive impairment

Severe cognitive impairment

Interpretation of MMSE Scores:

Score Degree of Impairment

Formal Psychometric Assessment

Day-to-Day Functioning

25-30 Questionably significant

If clinical signs of cognitive impairment are present, formal assessment of cognition may be valuable.

May have clinically significant but mild deficits. Likely to affect only most demanding activities of daily living.

20-25 Mild Formal assessment may be helpful to better determine pattern and extent of deficits.

Significant effect. May require some supervision, support and assistance.

10-20 Moderate Formal assessment may be helpful if there are specific clinical indications.

Clear impairment. May require 24-hour supervision.

0-10 Severe Patient not likely to be testable. Marked impairment. Likely to require 24-hour supervision and assistance with ADL.

Source: • Folstein MF, Folstein SE, McHugh PR: “Mini-mental state: A practical method for grading the cognitive

state of patients for the clinician.” J Psychiatr Res 1975;12:189-198.