Designated Medical Practitioner Handbook

Appendix IX: The Mini Mental State Examination

Patient’s Name:	Date of visit_______________
Orientation	Score		Maximum score
What is the year? What is the season? What is the date? What is the day What is the month? Where are we? Province Country Town Hospital/Building Floor/Office	_____ _____ _____ _____ _____		5 (1 for each)
	_____ _____ _____ _____ _____		5 (1 for each)
Registration
Examiner: Name three objects: 1 second to say each. Then ask the patient all three after you have said them. Give 1 point for each correct answer. Then repeat them until he/she learns all three. Count trials and record. Trials _____		_____	3
Attention & Calculation
Serial 7s. 1 point for each correct. Stop after 5 answers. 100___93___86___79___72___65___ Alternatively, spell “world” backwards DLROW		_____	5
Recall
Ask for the 3 objects above. Give 1 point for each correct.		_______	3
Language
Name a pencil and a watch (2 points) Repeat the following: “No ifs, and or buts.” (1 point) Follow a three-stage command: “Take a paper in your right hand, fold it in half and put it on the floor”. (3 points) Repeat and obey the following: Close your eyes (1 point) Write a sentence (1 point) Copy the design (1 point)		_____ _____ _____ _____ _____ _____ Total score___ / 30	9
Interpretation
26-30 “Normal” cognitive function 20-25 mild to moderate cognitive impairment Less than 20 moderate to severe cognitive treatment
Name and address of examining physician:
Signature:		Date:

It is important to establish a rapport and ensure the patient is comfortable before administering the test.

Orientation — Each question can be repeated a maximum of three times, and patients are allowed 10 seconds for each reply. Only exact answers are acceptable for all questions except for those on the date, month and season. A point can be scored for a response indicating the previous or following date, and during the transition period of seasons, either season is acceptable. On the first or last day of a month, a response of either month should be scored correct.

Registration — Patients are asked to repeat the names of three objects. A point is given for each correct reply on the first attempt. If all three words are not repeated, the examiner may repeat these until they are learned, to a maximum of six times. Tell patients that they must try to remember these objects because they will be asked to repeat them.

Attention concentration — The examiner can choose to ask patients to perform one of two tasks: either to serially subtract 7s starting at 100, or to spell a five-letter word like “world” backwards. If the patient fails the test, the alternative cannot then be offered. For spelling “world” backwards, the score awarded is for the number of letters given in the correct order.

Recall — Patients are told to repeat the three objects that they were previously asked to remember.

Language — Patients are shown a wristwatch and a pencil, and asked to name these objects. The repetition of a phrase like “No ifs, ands or buts” must be exact to be scored. Patients are shown the command “close your eyes” written in large letters and asked to do what it says. Patients may be reminded to do what it says. For the three-stage command, give the command as a single exercise and not as three sequential one-step commands. Patients are allowed 30 seconds to complete the task and awarded one point for each completed element.

Constructional ability — A point is scored when the drawing consists of two five-sided figures whose overlap forms a four-sided figure.

No comments should be made during this exam on the accuracy of answers given and no non-verbal clues should be displayed.

 

<< Contents | Previous | Next >>