1 / 3100%
The Mini-Mental State Test (MMSE), as described by Folstein, Folstein and McHugh (1975), is
the most commonly used method of cognitive screening. An examination of the psychometric
properties of MMSE would appear warranted as an accurate and complete evaluation of the
mental status of the elderly with cognitive impaired can have profound implications for the
quality of life (Amieva, et al. 2014). During clinical practice, nurses must not only use an
effective and exact evaluation tool during order to evaluate the cognitive condition, they must
also consider the physical condition and thus the cognitive impairment meaning, which may
impact patient results (Bozikas, Kosmidis, Gamvrula & Hatzigeorgadou, 2004).
Psychometric properties of Mini-Mental State Examination
The sensitivity and specificities of MMSE vary according to the cutoff used in different stages.
Studies have shown that this critical value is low (around (0,6) but has a high specificity (over
0,96). Other studies showed that, in 24/23 reductions, the sensitivity exceeds 0.8 for persons with
different severe dementia, while 0.54 for moderate dementia sensitivity (Trzepacz, Hochstetler,
Wang, Walker, & Saykin, 2015).
In a study carried out by Schramm and Berger, (2002) found only 0.18 sensitivity for mild
cognitive impairment, with a critical score of 26 points. The sensitivity was 0.78 with same cut
and the specificities 1. for Alzheimer's dementia detection MMSE is also a common research
method for cognitive impairment diagnosis of parkinson's disease. However, for this purpose,
MMSE seems to be something of a special device.
Trzepacz, et al. (2015) in his study propose to increase an overall sensitivity ratio limit value and
test specificity for recording cognitive dysfunction in Parkinson's disease subjects to 28/29
(sensitivity = 0.78; specificities = 0.63).
Bozikas VP, Kosmidis MH, Gamvrula and Hatzigeorgadou M, et al (2004) found that a 26-point
limit value could be somewhat stringent and must be lowered for determining cognitive
pathology. The MoCAs were only a complementary test to the MMSE as a routine, but they were
all targeted and tested for their diagnostic value. The most effective way to diagnose moderate
cognitive deficit was through the use of MoCA with the inclusion of 5 difficult elements of
MMSE (the three sentences repetition, the three terms reminiscent, repetition of the sentence, the
painting and pentagon drawing).
Explain when it is appropriate to use Mini-Mental State Examination tool with clients
In different phases, MMSE sensitivity and specificity differ depending on the cut-off used. This
critical value was found to have a low sensitivity (around (0.6), high specificity targets (over
0.96) (Bozikas, 2004). Similar research has shown that 24/23 cuts are 0.8 per person with
diversified, serious dementia but 0.54 per person with mild dementia (Trzepacz, et al 2015).
The sensitiveness to detection of slight cognitive impairment was identified by the Folstein MF,
Folstein SE, and McHugh PR (2000), with the critical score of 26 points. The severity of
Alzheimer syndrome was 0.78, while the specificity was 1. with the same cut-off. The MMSE is
also used as a traditional screening instrument in Parkinson's disease for cognitive disorder
diagnostics. But MMSE seems to be a small tool for this purpose.
In order to report cognitive dysfunction in subjects with Parkinson's disease, Hoops et al.(2009)
suggest to raise the limit value to the maximum sensitivity ratio and test specificity by 28/29
points (Sensitivity = 0.78; Specificity = 0.63)
The limited value of 26 points for cognitive pathology specifying may, Folstein MF, Folstein SE,
and McHugh PR (2000), found, be a little stringent and it should be reduced. Because of the fact
that MoCA still only serves as a complementary test of MMSE, both tests were combined and
their diagnostic values were confirmed by Trzepacz, et al. (2015). The MoCA was the best
choice for a moderate cognitive impairment diagnosis with five most difficult MMSE items (a 3-
word transcription, 3-word recording, repetition of the sentence, writing and drawing of a
Whether Mini-Mental State Examination can be used to evaluate the efficacy of
psychopharmacologic medications
The Minimal Mental State Examination (MMSE) is a widely-used tool that can be given with a
simple instruction in less than ten minutes to assess cognitive mental status. While it cannot be
used to make formal diagnosis, MMSE was a first step in cognitive impairment identification
Trzepacz, et al. (2015).
For the field of assessment and diagnostics in the literature, the measuring instruments are
recommended. Tests provide information on an individual's global cognitive status without a
neuropsychological test being needed. They are also used as a criterion for classifying
individuals into groups in study.
Amieva, h. - Mokri, h. - le Goff, m. - Meillon, c. - Jacqmin-Gadda, h. - Foubert-Samier, a. -
Orgogozo, j.-m. - Stern, y. - Dartigues, j.-f. (2014). Compensatory mechanisms in higher-
educated subjects with Alzheimer’s disease: a study of 20 years of cognitive decline. Brain,
2014. vol. 137.
Bozikas VP, Kosmidis MH, Gamvrula K, Hatzigeorgadou M, et al (2004), Clock drawing test in
patients with schizophrenia. Psychiatry research 121; p. 229-38
Folstein MF, Folstein SE, and McHugh PR (2000), Mini Mental State Examination (MMSE). In:
Task force for the handbook of psychiatric measures. 1th ed. American Psychiatric Association;
Schramm, U. - Berger, G. – (2002). Psychometric properties of Clock Drawing Test and MMSE
or Short Performance Test (SKT) in dementia screening in a memory clinic population. Int J
Geriatr Psychiatry, 2002. vol. 17, no. 3, pp. 254- 260. ISSN 0885-6230.
Trzepacz, P.T. - Hochstetler, H. - Wang, S. - Walker, B. - Saykin, A.J. (2015). Relationship
between the Montreal Cognitive Assessment and Mini-mental State Examination for assessment
of mild cognitive impairment in older adults. BMC Geriatrics, 2015. vol. 15, no. 1, pp. 1-9. ISSN
Students also viewed