The mini-mental state examination (MMSE) or Folstein test is a brief 30-point questionnaire test that is used to screen for cognitive impairment. It is commonly used in medicine Medicine is the art and science of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness to screen for dementia Dementia is a serious loss of cognitive ability in a previously-unimpaired person, beyond what might be expected from normal aging. It may be static, the result of a unique global brain injury, or progressive, resulting in long-term decline due to damage or disease in the body. Although dementia is far more common in the geriatric population, it. It is also used to estimate the severity of cognitive impairment at a given point in time and to follow the course of cognitive changes in an individual over time, thus making it an effective way to document an individual's response to treatment.

In the time span of about 10 minutes it samples various functions including arithmetic Arithmetic or arithmetics is the oldest and most elementary branch of mathematics, used by almost everyone, for tasks ranging from simple day-to-day counting to advanced science and business calculations. It involves the study of quantity, especially as the result of combining numbers. In common usage, it refers to the simpler properties when, memory In psychology, memory is an organism's ability to store, retain, and recall information. Traditional studies of memory began in the fields of philosophy, including techniques of artificially enhancing the memory. The late nineteenth and early twentieth century put memory within the paradigms of cognitive psychology. In recent decades, it has and orientation Orientation is a function of the mind involving awareness of three dimensions: time, place and person. Problems with orientation lead to disorientation, and can be due to various conditions, from delirium to intoxication. Typically, disorientation is first in time, then in place and finally in person. It was introduced by Folstein et al. in 1975,[1]. This test is not the same thing as a mental status examination The mental status examination abbreviated MSE, is an important part of the clinical assessment process in psychiatric practice. It is a structured way of observing and describing a patient's current state of mind, under the domains of appearance, attitude, behavior, mood and affect, speech, thought process, thought content, perception, cognition,. The standard MMSE form which is currently published by Psychological Assessment Resources is based on its original 1975 conceptualization, with minor subsequent modifications by the authors.

Various other tests are also used, such as the Hodkinson[2] abbreviated mental test score The abbreviated mental test score was introduced by Hodkinson in 1972 to rapidly assess elderly patients for the possibility of dementia. Its uses in medicine have become somewhat wider, e.g. to assess for confusion and other cognitive impairment, although it has mainly been validated in the elderly (1972, geriatrics Geriatrics is a subspecialty of medicine that focuses on health care of the elderly. It aims to promote health and to prevent and treat diseases and disabilities in older adults) or the General Practitioner Assessment Of Cognition The General Practitioner Assessment of Cognition is a brief screening test for cognitive impairment introduced by Brodaty et al in 2002. It was specifically developed for the use in the primary care setting as well as longer formal tests for deeper analysis of specific deficits.

Contents

The test

Interlocking pentagons used for the last question

The MMSE test includes simple questions and problems in a number of areas: the time and place of the test, repeating lists of words, arithmetic such as the serial sevens Serial sevens, counting down from one hundred by sevens, is a clinical test used to test mental function; for example, to help assess mental status after possible head injury or in suspected cases of dementia. It forms part of the Mini mental state examination, language use and comprehension, and basic motor skills. For example, one question asks to copy a drawing of two pentagons (shown on the right).[1]

Although consistent application of identical questions increases the reliability of comparisons made using the scale, the test is sometimes customized (for example, for use on patients that are intubated In medicine, intubation refers to the placement of a tube into an external or internal orifice of the body. Although the term can refer to endoscopic procedures, it is most often used to denote tracheal intubation. Tracheal intubation is the placement of a flexible plastic tube into the trachea to protect the patient's airway and provide a means, blind, or partially immobilized. Also, some have questioned the use of the test on the deaf Hearing impairment or deafness refers to conditions in which individuals are fully or partially unable to detect or perceive at least some frequencies of sound which can typically be heard by members of their species. Use of the term impaired implies that deafness presents an inherent disadvantage to an animal, a view that is rejected within the.[3]) However, the number of points assigned per category is usually consistent:

Category Possible points Description
Orientation to time 5 From broadest to most narrow. Orientation to time has been correlated with future decline.[4]
Orientation to place 5 From broadest to most narrow. This is sometimes narrowed down to streets,[5] and sometimes to floor.[6]
Registration 3 Repeating named prompts
Attention and calculation 5 Serial sevens Serial sevens, counting down from one hundred by sevens, is a clinical test used to test mental function; for example, to help assess mental status after possible head injury or in suspected cases of dementia. It forms part of the Mini mental state examination, or spelling "world" backwards[7] It has been suggested that serial sevens may be more appropriate in a population where English is not the first language.[8]
Recall 3 Registration recall
Language 2 Name a pencil and a watch
Repetition 1 Speaking back a phrase
Complex commands 6 Varies. Can involve drawing figure shown.

Interpretation

Any score greater than or equal to 25 points (out of 30) is effectively normal (intact). Below this, scores can indicate severe (≤9 points), moderate (10-20 points) or mild (21-24 points)[9]. The raw score may also need to be corrected for educational attainment and age.[10] Low to very low scores correlate closely with the presence of dementia Dementia is a serious loss of cognitive ability in a previously-unimpaired person, beyond what might be expected from normal aging. It may be static, the result of a unique global brain injury, or progressive, resulting in long-term decline due to damage or disease in the body. Although dementia is far more common in the geriatric population, it, although other mental disorders can also lead to abnormal findings on MMSE testing. The presence of purely physical problems can also interfere with interpretation if not properly noted; for example, a patient may be physically unable to hear or read instructions properly, or may have a motor deficit that affects writing and drawing skills.

Copyright issues

Originally, the MMSE was distributed widely for free. However, the current version of the MMSE is owned by copyright Copyright is the set of exclusive rights granted to the author or creator of an original work, including the right to copy, distribute and adapt the work. Copyright lasts for a certain time period after which the work is said to enter the public domain. Copyright applies to a wide range of works that are substantive and fixed in a medium. Some owner Psychological Assessment Resources (PAR). Despite the many free versions of the test that are available on the internet, the official version is copyrighted and must be ordered through PAR.[11][12] The enforcement of the copyright on the MMSE has been compared to "stealth", or "submarine Submarine patent is an informal term for a patent first published and granted long after the initial application was filed. In analogy to a submarine, its presence is unknown to the public; it stays under water, i.e., unpublished, for long periods, then emerges, i.e., granted and published, and surprises the relevant market. This practice was" patents A patent is a set of exclusive rights granted by a state (national government) to an inventor or their assignee for a limited period of time in exchange for a public disclosure of an invention, where a patent applicant would wait until an invention gains widespread popularity until allowing the patent to issue and only then commencing enforcement (such patent applications are no longer possible with changes made to the patent term).[11] The enforcement of the copyright has led to researchers looking for alternative strategies in assessing cognition.[13][14]

See also

References

  1. ^ a b Folstein MF, Folstein SE, McHugh PR (1975). ""Mini-mental state". A practical method for grading the cognitive state of patients for the clinician". Journal of psychiatric research 12 (3): 189–98. doi A digital object identifier is a character string used to uniquely identify an electronic document or other entity. The DOI for a document remains fixed over the lifetime of the document, unlike URLs which can change when a publisher of online content changes its web server's file structure, and the DOI System provides a mechanism for locating an:10.1016/0022-3956(75)90026-6. PMID A PMID is a unique number assigned to each PubMed citation of life sciences and biomedical scientific journal articles. The related Pubmed Central archive may additionally assign a separate number, a PMCID (PubMed Central Identifier), normally written with a PMC prefix 1202204.
  2. ^ Hodkinson HM (1972). "Evaluation of a mental test score for assessment of mental impairment in the elderly". Age and ageing 1 (4): 233–8. doi A digital object identifier is a character string used to uniquely identify an electronic document or other entity. The DOI for a document remains fixed over the lifetime of the document, unlike URLs which can change when a publisher of online content changes its web server's file structure, and the DOI System provides a mechanism for locating an:10.1093/ageing/1.4.233. PMID A PMID is a unique number assigned to each PubMed citation of life sciences and biomedical scientific journal articles. The related Pubmed Central archive may additionally assign a separate number, a PMCID (PubMed Central Identifier), normally written with a PMC prefix 4669880.
  3. ^ Dean PM, Feldman DM, Morere D, Morton D (December 2009). "Clinical evaluation of the mini-mental state exam with culturally deaf senior citizens". Arch Clin Neuropsychol 24 (8): 753–60. doi A digital object identifier is a character string used to uniquely identify an electronic document or other entity. The DOI for a document remains fixed over the lifetime of the document, unlike URLs which can change when a publisher of online content changes its web server's file structure, and the DOI System provides a mechanism for locating an:10.1093/arclin/acp077. PMID A PMID is a unique number assigned to each PubMed citation of life sciences and biomedical scientific journal articles. The related Pubmed Central archive may additionally assign a separate number, a PMCID (PubMed Central Identifier), normally written with a PMC prefix 19861331. http://acn.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=19861331.
  4. ^ Guerrero-Berroa E, Luo X, Schmeidler J, et al. (December 2009). "The MMSE orientation for time domain is a strong predictor of subsequent cognitive decline in the elderly". Int J Geriatr Psychiatry 24 (12): 1429–37. doi A digital object identifier is a character string used to uniquely identify an electronic document or other entity. The DOI for a document remains fixed over the lifetime of the document, unlike URLs which can change when a publisher of online content changes its web server's file structure, and the DOI System provides a mechanism for locating an:10.1002/gps.2282. PMID A PMID is a unique number assigned to each PubMed citation of life sciences and biomedical scientific journal articles. The related Pubmed Central archive may additionally assign a separate number, a PMCID (PubMed Central Identifier), normally written with a PMC prefix 19382130. http://dx.doi.org/10.1002/gps.2282.
  5. ^ Morales LS, Flowers C, Gutierrez P, Kleinman M, Teresi JA (November 2006). . Med Care 44 (11 Suppl 3): S143–51. doi A digital object identifier is a character string used to uniquely identify an electronic document or other entity. The DOI for a document remains fixed over the lifetime of the document, unlike URLs which can change when a publisher of online content changes its web server's file structure, and the DOI System provides a mechanism for locating an:10.1097/01.mlr.0000245141.70946.29. PMID A PMID is a unique number assigned to each PubMed citation of life sciences and biomedical scientific journal articles. The related Pubmed Central archive may additionally assign a separate number, a PMCID (PubMed Central Identifier), normally written with a PMC prefix 17060821. PMC PubMed Central is a free digital database of full-text scientific literature in biomedical and life sciences. It grew from the online Entrez PubMed biomedical literature search system. PubMed Central was developed by the U.S. National Library of Medicine as an online archive of biomedical journal articles 1661831. .
  6. ^ "MMSE". http://www.utmb.edu/psychology/ClinPsych/MiniMental.htm. Retrieved 2009-12-10.
  7. ^ Ganguli M, Ratcliff G, Huff FJ, et al. (1990). "Serial sevens versus world backwards: a comparison of the two measures of attention from the MMSE". J Geriatr Psychiatry Neurol 3 (4): 203–7. PMID A PMID is a unique number assigned to each PubMed citation of life sciences and biomedical scientific journal articles. The related Pubmed Central archive may additionally assign a separate number, a PMCID (PubMed Central Identifier), normally written with a PMC prefix 2073308.
  8. ^ Espino DV, Lichtenstein MJ, Palmer RF, Hazuda HP (May 2004). "Evaluation of the mini-mental state examination's internal consistency in a community-based sample of Mexican-American and European-American elders: results from the San Antonio Longitudinal Study of Aging". J Am Geriatr Soc 52 (5): 822–7. doi A digital object identifier is a character string used to uniquely identify an electronic document or other entity. The DOI for a document remains fixed over the lifetime of the document, unlike URLs which can change when a publisher of online content changes its web server's file structure, and the DOI System provides a mechanism for locating an:10.1111/j.1532-5415.2004.52226.x. PMID A PMID is a unique number assigned to each PubMed citation of life sciences and biomedical scientific journal articles. The related Pubmed Central archive may additionally assign a separate number, a PMCID (PubMed Central Identifier), normally written with a PMC prefix 15086669. http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0002-8614&date=2004&volume=52&issue=5&spage=822.
  9. ^ Mungas, D (1991). "In-office mental status testing: a practical guide". Geriatrics 46 (7): 54-56.
  10. ^ Crum RM, Anthony JC, Bassett SS, Folstein MF (May 1993). "Population-based norms for the Mini-Mental State Examination by age and educational level". JAMA 269 (18): 2386–91. doi A digital object identifier is a character string used to uniquely identify an electronic document or other entity. The DOI for a document remains fixed over the lifetime of the document, unlike URLs which can change when a publisher of online content changes its web server's file structure, and the DOI System provides a mechanism for locating an:10.1001/jama.269.18.2386. PMID A PMID is a unique number assigned to each PubMed citation of life sciences and biomedical scientific journal articles. The related Pubmed Central archive may additionally assign a separate number, a PMCID (PubMed Central Identifier), normally written with a PMC prefix 8479064.
  11. ^ a b Powsner S, Powsner D (2005). "Cognition, copyright, and the classroom". The American journal of psychiatry 162 (3): 627–8. doi A digital object identifier is a character string used to uniquely identify an electronic document or other entity. The DOI for a document remains fixed over the lifetime of the document, unlike URLs which can change when a publisher of online content changes its web server's file structure, and the DOI System provides a mechanism for locating an:10.1176/appi.ajp.162.3.627-a. PMID A PMID is a unique number assigned to each PubMed citation of life sciences and biomedical scientific journal articles. The related Pubmed Central archive may additionally assign a separate number, a PMCID (PubMed Central Identifier), normally written with a PMC prefix 15741491. http://ajp.psychiatryonline.org/cgi/content/full/162/3/627-a.
  12. ^ "Mini-Mental State Examination. Psychological Assessment Resources, Inc.". http://www.minimental.com/. Retrieved 2006-06-22.
  13. ^ Holsinger T, Deveau J, Boustani M, Williams JW (June 2007). "Does this patient have dementia?". JAMA 297 (21): 2391–404. doi A digital object identifier is a character string used to uniquely identify an electronic document or other entity. The DOI for a document remains fixed over the lifetime of the document, unlike URLs which can change when a publisher of online content changes its web server's file structure, and the DOI System provides a mechanism for locating an:10.1001/jama.297.21.2391. PMID A PMID is a unique number assigned to each PubMed citation of life sciences and biomedical scientific journal articles. The related Pubmed Central archive may additionally assign a separate number, a PMCID (PubMed Central Identifier), normally written with a PMC prefix 17551132. http://jama.ama-assn.org/cgi/content/full/297/21/2391.
  14. ^ Mini-Mental State Exam (MMSE) Copyright, M. Smith, University of Iowa College of Nursing
Medical records A medical record, health record, or medical chart is a systematic documentation of a patient's medical history and care. The term 'Medical record' is used both for the physical folder for each individual patient and for the body of information which comprises the total of each patient's health history. Medical records are intensely personal
Admission note An admission note is written for patients to be admitted to a hospital. It is possible for multiple admission notes to be written for a single patient

H and P (history The medical history or anamnesis of a patient is information gained by a physician by asking specific questions, either of the patient or of other people who know the person and can give suitable information (in this case, it is sometimes called heteroanamnesis), with the aim of obtaining information useful in formulating a diagnosis and providing and physical): Chief complaint The Chief Complaint , or termed Presenting Complaint (PC) in the UK, is a concise statement describing the symptom, problem, condition, diagnosis, physician recommended return, or other factor that is the reason for a medical encounter. The patient's initial comments to a physician, nurse, or other health care professional help form the · History of the present illness In a medical encounter, a history of the present illness (termed history of presenting complaint (HPC) in the UK) refers to a detailed interview prompted by the chief complaint or presenting symptom (for example, pain) (SAMPLE history SAMPLE history is an mnemonic acronym for first responders to remember key questions for patient assessment. The history is usually taken along with vital signs. This is used for alert patients, but often much of this information can also be obtained from the family of an unresponsive patient, OPQRST OPQRST is an mnemonic initialism used by persons performing first aid, or medical providers, in order to facilitate taking a patient's symptoms and history in the event of an acute illness. It is specifically adapted to elicit symptoms of a possible heart attack. Each letter stands for an important line of questioning for the patient assessment) · Past medical history In a medical encounter, a past medical history , is the total sum of a patient's health status prior to the presenting problem · Family history · Social history · Review of systems · Physical examination (Vital signs)

Psychiatric history · Mental status examination · Mini-mental state examination

other: Labs · Assessment and plan (Medical diagnosis, Differential diagnosis)
Progress note SOAP note
Medical privacy

Categories: Psychiatry | Cognitive tests | Neuropsychological tests | Memory tests | Geriatrics

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