Mini Mental State Examination (MMSE) is developed by Dr Marshall Folstein in the 1970s, and is extensively used in the US and UK .

The MMSE is a short quantitative evaluation of thinking abilities or disabilities of the adults. It can be utilized to look for disabilities in mental faculties and to estimate the degree of disabilities. The mental faculties consist of memory, thinking, reasoning, attention, decision making and thinking up ideas. This examination is not apt for making a diagnosis but can be utilized to point the existence of mental disabilities in a person.

People, who are not educated or with different cultural backgrounds, may not be able to score high points even with all their mental faculties intact. Educated people, even with mental impairment, may score high in MMSE. The test takes only about 10 minutes, but it does not deal with memory losses in educated people.

The MMSE presents assessment of orientation, registration (instantaneous memory), short-term memory (but not long-term memory) as well as language tasking. The examination has been authenticated in a number of populations. Scores of 25-30 out of 30 are considered normal, 18-24 indicate mild to moderate impairment, and scores of 17 or less indicate severe impairment.

Interpretation of Mini-Mental State Examination Score(Maximum: 30)

A. Normal score: 24 or higher

B. Educational and Age Norms

Fourth Grade Education

a. Ages 18 to 69: Median MMSE Score 22-25

b. Ages 70 to 79: Median MMSE Score 21-22

c. Age over 79: Median MMSE Score 19-20

Eighth Grade Education

a. Ages 18 to 69: Median MMSE Score 26-27

b. Ages 70 to 79: Median MMSE Score 25

c. Age over 79: Median MMSE Score 23-25

High School Education

a. Ages 18 to 69: Median MMSE Score 28-29

b. Ages 70 to 79: Median MMSE Score 27

c. Age over 79: Median MMSE Score 25-26

College Education

a. Ages 18 to 69: Median MMSE Score 29

b. Ages 70 to 79: Median MMSE Score 28

c. Age over 79: Median MMSE Score 27

Mini Mental State Examination (MMSE) Orientation What is the year, season, date, day and month (1 point for each; maximum total 5 points). Where are we: town, county, country, which hospital, surgery or house, and which floor (1 point for each; maximum total 5 points). Registration Name 3 objects. Ask to repeat the names of all 3 objects. Give 1 point for each correct answer. Repeat the object names until all 3 are learned (up to 6 trials). Attention and Calculation Spell "world" backwards. Give 1 point for each letter that is in the right place Alternatively, do serial 7s. Ask the person to count backwards from 100 in blocks of 7 Stop after 5 subtractions. Give one point for each correct answer Recall Ask for the 3 objects in registration above to be repeated. Give 1 point for each correct object (maximum total 3 points). Language Ask to name two subjects. Two points to the objects named. One point for an accurate repetition of the phrase: 'No ifs, ands or buts'. Ask to follow a 3-stage command: "Take paper in your right hand, fold it in half and put it on the floor" (1 point for each part that is correctly followed). (maximum total 3 points) Ask the person to write "CLOSE YOUR EYES" on a paper Ask to follow the written one. One point if they actually close their eyes. Ask the individual to write complete sentence. See if it contains a subject and a verb, and must make sense. Give one point. Show the person a drawing of 2 pentagons which intersect to form a quadrangle. Ask to copy the design exactly. One point to score.

Score over 27 out of 30 is considered normal. Scores between 20 and 26 is considered a milder state of dementia. Moderate dementia is indicated if the score falls between 10 and 19. The normal value is also corrected for level of education and age. Low to very low scores also correspond to the presence of dementia. Prevalence of mental disorders will also give distorted figures. The examinee’s current physical condition also affects scores, such as hearing problems, sight problems etc.