Acronym for Mental State Examination

Items: The MMSE consists of 11 simple questions or tasks that look at various functions including: arithmetic, memory and orientation.

Scoring:
The score is the number of correct items. The measure yields a total score of 30. A score of 23 or less is the generally accepted cutoff point indicating the presence of cognitive impairment (Ruchinskas & Curyto, 2003).

Levels of impairment have also been classified as none (24-30); mild (18-23) and severe (0-17) (Tombaugh & McIntyre 1992).

More recently, Folstein, Folstein, McHugh, and Fanjiang. (2001) recommended the following cutoff scores:

Score Level of impairment

Crum et al. (1993) reported that cognitive performance as measured by the MMSE varies within the population by age and educational level. There is an inverse relationship between MMSE scores and age, ranging from a median of 29 for those aged 18 to 24 years, to 25 for individuals 80 years of age and older. There is also an inverse relationship between MMSE scores and education. The median MMSE score is 29 for individuals with at least 9 years of schooling, 26 for those with 5 to 8 years of schooling, and 22 for those with 0 to 4 years of schooling.

The following table, created by Crum et al. (1993) can be used to compare your patient’s MMSE score with a reference group based on age and education level.

(Source: Crum et al., 1993)

Age
Education 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 >84
4th grade 22 25 23 21 20 19
8th grade 27 26
PEDro score*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: ">High school
29 28
College

Subscales:
Orientation (total points = 10), Registration (total points = 3), Attention and calculation (total points = 5), Recall (total points = 3), and Language (total points = 9).

Equipment:
The MMSE requires no specialized equipment.

Training:
Little information has been reported on training for the MMSE, however a standardized version of the MMSE has been developed (Molloy & Standish, 1997).

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