Mental State Examination speech

What to Look for in Assessment

One of the key diagnostic tests for dementias such as Alzheimer's is the Mental Status Examination (MSE). The doctor/clinician makes judgments on the way the 'patient' is functioning in a number of key areas. These components of the MSE cannot be judged in isolation. Each aspect will contribute to a diagnosis. There are many forms of mental illness and disorder that will show abnormalities in these areas but it is the combination of abnormality, together with other diagnostic tests that lead to a 90% to 95% probability of Alzheimer's Disease.

Mental Status Examination Evaluates:
Affect and Mood
Attitude
Appearance
Behavior
Cognition
Insight Judgement
Speech and language
Thought content
Thought processes.

Affect Mood, Mental Status Examination and Alzheimer's Diagnosis
Affect is about the emotion behind the actions, the emotional state of an individual.

The doctor will be looking at mood as well as the appropriateness of emotion that the person is expressing. People with Alzheimer's disease may show inappropriate affect and mood.

Appearance, Attitude, Behavior, the Mental Status Examination and Alzheimer's Diagnosis
People with Alzheimer's disease may show signs of their inability to carry out basic tasks such as washing, dressing appropriately, combing their hair etc. The person may walk in a particular way, be unsteady, be restless, apathetic, anxious pace or wander about the consulting area.

How someone presents and behaves to others, their attitude can tell us a number of things. Are they friendly, suspicious, confused, are they able to express themselves properly, interact with others?

Cognition, Mental Status Examination and Alzheimer's Diagnosis
Cognition is the ability to think. Attention, reasoning, decision making and dealing with concepts are all affected in Alzheimer's as is ability to and carry out tasks in a logical and sequential way.

Insight Judgement, Mental Status Examination and Alzheimer's Diagnosis
Key elements in the MSE is whether an individual has insight into their condition and circumstances.

An ability to make judgements about things and act on them deteriorates significantly in dementia.

Speech Language, Mental Status Examination and Alzheimer's Diagnosis
People with Alzheimer's disease may show particular abnormalities in their speech and language. Aphasia is a major symptom of Alzheimer's disease and dementia. Also of interest to a clinician will be the way in which people talk, the volume and tone.

Thought Content, Thought Processes, Mental Status Examination and Alzheimer's Diagnosis
The way in which people with dementia such as Alzheimer's think and their thought content will be disrupted. This may be a direct result of the brain damage that occurs in Alzheimer's or it could be because of associated conditions such as psychosis or depression, suicidal ideation.

Assessing the mental health of an individual begins as soon as the clinicians greets his/her 'patient'. Their findings will contribute to a possible diagnosis of dementias such as Alzheimer's disease.

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Q&A

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What is the Mini Mental State Examination (MMSE)?

The Mini Mental State Examination (MMSE) is the most commonly used test for complaints of memory problems or when a diagnosis of dementia is being considered and is carried out by a medical professional.

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What is medical definition of Mini-Mental State Examination?

a brief psychologic test designed to differentiate among dementia, psychosis, and affective disorders. It may include ability to count backward by 7s from 100, to identify common objects such as a pencil and a watch, to write a sentence, to spell simple words backward, and to demonstrate orientation by identifying the day, month, and year, as well as town and country.

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