Mini Mental State Examination (MMSE)

The mini mental state examination (MMSE)¹ is the most commonly used instrument for screening cognitive function. This examination is not suitable for making a diagnosis but can be used to indicate the presence of cognitive impairment, such as in a person with suspected dementia or following a head injury.² The MMSE is far more sensitive in detecting cognitive impairment than the use of informal questioning or overall impression of a patient's orientation.

• The test takes only about 10 minutes, but is limited because it will not detect subtle memory losses, particularly in well-educated patients.³
• People from different cultural groups, or of low intelligence or education, may score poorly on this examination in the absence of cognitive impairment⁴ and well-educated people may score well despite having cognitive impairment.⁵
• The MMSE provides measures of orientation, registration (immediate memory), short-term memory (but not long-term memory) as well as language functioning.
• The examination has been validated in a number of populations. Scores of 25-30 out of 30 are considered normal; 18-24 indicate mild-to-moderate impairment; scores of 17 or less indicate severe impairment.

Before administering the MMSE it is important to make the patient comfortable and to establish a rapport with the patient. Praising success may help to maintain the rapport and is acceptable, but persisting on items the patient finds difficult should be avoided.

The mini-mental state examination was originally distributed free, but the current copyright holders are Psychological Assessment Resources (PAR) who "will not grant permission to include or reproduce an entire test or scale in any publication (including dissertations and theses) or on any website ".⁶ All users will need to purchase the tests from PAR.

We regret therefore that we have removed further details of the test from this site. GPs may prefer to use the General Practitioner's Assessment of Cognition (GPCOG) Score test.