- The Folstein Mini-Mental State Examination (test of cognitive function)
- Instructions for Administration of Mini-Mental State Examination
- References
The Folstein Mini-Mental State Examination (test of cognitive function)
| Maximum Score | Orientation |
|---|---|
| 5 | What is the (year) (season) (date) (day) (month)? |
| 5 | Where are we: (state) (county) (town) (hospital) (floor)? |
| Registration | |
| 3 | Name 3 objects: 1 second to say each. Then ask the patient all 3 after you have said them. Give 1 point for each correct answer. Then repeat them until he learns all 3. Count trials and record. Trials ________ |
| Attention and Calculation | |
| 5 | Serial 7's. 1 point for each correct. Stop after 5 answers. Alternatively spell "world" backwards. |
| Recall | |
| 3 | Ask for 3 objects repeated above. Give 1 point for each correct. |
| Language | |
| 2 | Name a pencil and watch. |
| 1 | Repeat the following: "No ifs, ands, or buts." |
| 3 | Follow a 3 stage command: "Take a paper in your right hand, fold it in half, and put it on the floor." |
| 1 | Read and obey the following: |
| CLOSE YOUR EYES | |
| 1 | Write a sentence. |
| 1 | Copy design. |
| 30 |
ASSESS level of consciousness along a continuum (alert, drowsy, stupor, coma)
Instructions for Administration of Mini-Mental State Examination
Ask for the date. Then ask specifically for parts omitted (e.g., "Can you also tell me what season it is?") One point for each correct.
Ask in turn "Can you tell me the name of this hospital?" (town, county, etc.). One point for each correct.
Ask the patient if you may test his memory. Then say the names of three unrelated objects, clearly and slowly, about one second for each. After you have said all three, ask him to repeat them. This first repetition determines his score (0–3), but keep saying them until he can repeat all three, up to six trials. If he does not eventually learn all three, recall cannot be meaningfully tested.
Ask the patient to begin with 100 and count backwards by 7. Stop after 5 subtractions (93, 86, 79, 72, 65). Score the total number of correct answers.
If the patient cannot or will not perform this task, ask him to spell the word "world" backwards. The score is the number of letters in correct order (e.g., dlrow = 5, dlorw = 3).
Ask the patient if he can recall the three words you previously asked him to remember. Score 0–3.
Naming: Show the patient a wrist watch and ask him what it is. Repeat for pencil. Score 0–2.
Repetition: Ask the patient to repeat the sentence after you. Allow only one trial. Score 0 or 1.
3-Stage command: Give the patient a piece of plain blank paper and repeat the command. Score 1 point for each part correctly executed (Folstein, et al., 1975, p. 197).
Scoring: A score of 20 or less has been found "only in patients with dementia, delirium, schizophrenia or affective disorders" (Folstein, et al., 1975, p. 196). The MMS is not timed and should only take about 5-10 minutes (Folstein, et al., 1975, p. 189).
- Folstein, MF, Folstein, SE, and McHugh, PR: Mini-mental state. Journal of Psychiatric Research, 12(1):189-198, 1975.
- Gallo, JJ, Reichel, W, and Andersen, LM: Handbook of Geriatric Assessment. Aspen, Gaithersburg, MD, 1995.
| NOTE: Some changes in administration and scoring have occurred over the years based on research. Gallo, Reichel, and Andersen (1995, p. 33) used a "cutoff score of 24 ... to indicate dementia." Scores may vary based on formal education completed and age. |
| SOURCE: Adapted from Folstein, MF, Folstein, SE, and McHugh, PR: Mini-mental state. Journal of Psychiatric Research, 12(1):196-197, 1975. Used with permission. |