Mini-Mental State Examination
Original Editor - Simisola Ajeyalemi
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The Mini-mental state examination is used to measure cognitive impairment in older adults. According to Folstein et al, it can be used to screen for cognitive impairment, to estimate the severity of cognitive impairment at a given point in time, to follow the course of cognitive changes in an individual over time, and to document an individual’s response to treatment. It assesses different subset of cognitive status including attention, language, memory, orientation, visuospatial proficiency. It has also been recommended for the screening of cognition in depressed patients The mini-mental state examination is proprietary and takes about 10-15 minutes to administer.
According to some studies, 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. However, it should not be used to exclusively diagnose or differentiate the different types of dementia.
The Mini-Cog and revised Addenbrooke's Cognitive Examination are preferred alternatives to the Mini-Mental State Examination for dementia screening, and the Montreal Cognitive Assessment is a preferred alternative to detect mild cognitive impairment.
Scoring and Interpretation of Scores
The Mini-mental state examination is scored on a scale of 0-30 with scores > 25 interpreted as normal cognitive status.
- Severe cognitive impairment: 0-17
- Mild cognitive impairment: 18-23
- No cognitive impairment: 24-30
Interpretation of the mental status examination must take into account the patient's native language, education level, and culture as these factors can affect perfromance.
In 14 studies, the MMSE had a sensitivity of 88.3% (95% confidence interval [CI], 81.3% to 92.9%) and a specificity of 86.2% (95% CI, 81.8% to 89.7%) for dementia, with a score cutoff of 23 to 25 indicating significant impairment. A more recent meta-analysis of 108 cohort studies found a sensitivity of 81% (95% CI, 78% to 84%) and specificity of 89% (95% CI, 87% to 91%)
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