Mini-Mental State Examination (MMSE) Calculator

Ask: What is the year? Season? Date? Day of the week? Month? (1 point each)

Ask: Where are we? State? County? Town/City? Building? Floor/Room? (1 point each)

Name 3 objects, then ask patient to repeat them. Score 1 point for each correct answer on first attempt.

Serial 7s: Subtract 7 from 100, then continue subtracting 7 from each answer (100, 93, 86, 79, 72, 65). OR spell "WORLD" backwards. Score 1 point for each correct answer.

Ask patient to recall the 3 objects from Registration. Score 1 point for each correct answer.

Tasks include: Name 2 objects (2 pts), Repeat phrase (1 pt), 3-stage command (3 pts), Read and obey "Close your eyes" (1 pt), Write sentence (1 pt), Copy design (1 pt)

How long does it take to administer the MMSE?

The MMSE typically takes 5-10 minutes to administer. It should be conducted in a quiet environment with minimal distractions. The brevity of the test makes it practical for routine clinical use, though this also means it cannot assess all aspects of cognitive function in depth.

Can MMSE diagnose Alzheimer's disease or dementia?

No, the MMSE is a screening tool, not a diagnostic test. While it can detect cognitive impairment, it cannot diagnose specific conditions like Alzheimer's disease. Diagnosis requires comprehensive evaluation including detailed history, physical examination, neuropsychological testing, laboratory work, and brain imaging. The MMSE is just one component of this evaluation.

What score indicates dementia?

Generally, scores below 24 suggest cognitive impairment, but the cutoff should be adjusted for education level. For those with less than 8 years of education, scores below 21 may indicate impairment. For those with higher education, even scores of 24-26 may warrant further investigation. Context and clinical judgment are essential in interpreting MMSE scores.

How often should MMSE be repeated?

For monitoring diagnosed dementia, MMSE can be repeated every 6-12 months to track progression. More frequent testing (every 3-6 months) may be appropriate when starting new medications or if rapid decline is suspected. However, practice effects can occur with frequent testing, so results should be interpreted cautiously.

Are there alternatives to the MMSE?

Yes, alternatives include the Montreal Cognitive Assessment (MoCA), which is more sensitive for mild cognitive impairment; the Mini-Cog, which is faster; and the Saint Louis University Mental Status (SLUMS) examination. Each has advantages and disadvantages. Comprehensive neuropsychological testing provides the most detailed assessment but requires specialized training and more time.

What should I do if MMSE shows cognitive impairment?

Consult a healthcare provider for comprehensive evaluation. This should include detailed medical history, medication review, physical and neurological examination, depression screening, laboratory tests (B12, thyroid, metabolic panel), and possibly brain imaging. Many causes of cognitive impairment are treatable, including medication effects, depression, vitamin deficiencies, and thyroid disorders.

Can MMSE scores improve over time?

Yes, if cognitive impairment was due to reversible causes like depression, delirium, medication effects, or vitamin deficiencies. In progressive dementias like Alzheimer's disease, scores typically decline over time, though the rate varies. Dementia medications may stabilize scores temporarily but don't typically cause sustained improvement.

Should family members be present during MMSE testing?

The MMSE should be administered one-on-one without family members present during testing to avoid coaching or assistance. However, family members can provide valuable collateral history about cognitive changes, functional decline, and behavioral symptoms before or after the test. Their input is crucial for comprehensive assessment.