MMSE Evaluation Tool for Detecting Cognitive Impairment

The Mini-mental state examination (MMSE) is an evaluation tool used to detect cognitive impairment. It comprises of a questionnaire that includes 30 questions and based upon the response the degree of cognitive impairment is diagnosed by the clinicians and researchers. The MMSE evaluation tool is used for the screening of dementia and detecting behavioral changes in the patients. The strengths, weaknesses, and cautions of the tool are discussed in this article.

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Source:
The Folstein test or the Mini-mental state examination is an evaluation tool that is used in
order to detect the level of cognitive impairment (Arevalo‐Rodriguez et al., 2017). It was
developed in the year 1975 by a group of researchers who aimed to develop an evaluation tool
that would help in successfully differentiating an organic psychiatric patient from a functional
one. It comprises of a questionnaire that includes 30 questions and based upon the response the
degree of cognitive impairment is diagnosed by the clinicians and researchers. The MMSE
evaluation tool is used for the screening of dementia and detecting behavioral changes in the
patients. The tool also effectively helps in the efficient tracking of the changes in the patient’s
behavior so as to understand the level of improvement manifested through the use of medication
and appropriate interventions.
Use:
The test is conducted within a time-duration of approximately 5 to 10 minutes. The test
specifically focuses on the ability of the patients to recall a particular incident, time taken to
respond to a question, the level of focus and concentration and the ability to perform a simple
calculation. It further evaluates the patient’s ability to follow simple commands and the speech
orientation. It should be noted here that a score equivalent to 24 points or more represents null
cognitive impairment features. A score range between 18-23 represents mild cognitive
impairment, whereas a score range between 0-17 represents severe cognitive impairment and
incidence of dementia that needs further evaluation (Yajima et al., 2014).

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Strength:
The strengths of using the MMSE evaluation tool could be enlisted as no requirement of
professional training or expertise in conducting the evaluation. However, it should be noted here
that the evaluated responses can be potentially used for the diagnostic criteria and longitudinal
assessment of Alzheimer’s disease (Creavin et al., 2016). On account of the convenience in
handling the evaluation procedure, it is widely used by the clinicians and therapists to assess a
patient in the initial stage of mental illness.
Weakness:
The weaknesses would include the influence of demographic factors such as age and
education background of the patients being screened by the mentioned assessment tool. Further,
the evaluation tool is not equipped enough to trace the mild cognitive impairment indication. In
addition to this the evaluation tool does not successfully differentiate between the patients who
have mild Alzheimer’s ideation from stable patients. It should further be noted that researchers
have criticized the efficacy of the tool in being able to detect the progressive changes occurring
in the patients who are affected with Alzheimer’s disease (Buckinham et al., 2017). It has also
been argued by researchers that the MMSE evaluation tool primarily relied upon the verbal
response of the patients and hence the criteria to measure the visuospatial or constructional
praxis and focal lesions is often is often overlooked and unaddressed (Buckinham et al., 2017).
Caution:
It is advised that MMSE evaluation should only be used with patients who are at least
grade 8 qualified and possess the ability to speak English fluently. This is primarily ensured in

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order to avoid any discrepancy in the MMSE score based upon the education and linguistic
background of the patients.

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References:
Arevalo‐Rodriguez, I., Smailagic, N., i Figuls, M. R., Ciapponi, A., Sanchez‐Perez, E.,
Giannakou, A., ... & Cullum, S. (2015). Mini‐Mental State Examination (MMSE) for the
detection of Alzheimer's disease and other dementias in people with mild cognitive
impairment (MCI). Cochrane Database of Systematic Reviews, (3).
Buckingham, D. N., Mackor, K. M., Miller, R. M., Pullam, N. N., Molloy, K. N., Grigsby, C. C.,
... & Winningham, R. G. (2013). Comparing the cognitive screening tools: MMSE and
SLUMS. Pure Insights, 2(1), 3.
Creavin, S. T., Wisniewski, S., Noel‐Storr, A. H., Trevelyan, C. M., Hampton, T., Rayment,
D., ... & Patel, A. S. (2016). Mini‐Mental State Examination (MMSE) for the detection of
dementia in clinically unevaluated people aged 65 and over in community and primary
care populations. Cochrane Database of Systematic Reviews, (1).
Yajima, K., Matsushita, T., Sumitomo, H., Sakurai, H., Katayama, T., Kanno, K., ... &
Nishimura, K. (2014). One‐minute mental status examination for category fluency is
more useful than mini‐mental state examination to evaluate the reliability of insulin self‐
injection in elderly diabetic patients. Journal of diabetes investigation, 5(3), 340-344.