Mini-Mental State Examination (MMSE)

Technical Sheet and Application Objectives

The Mini-Mental State Examination (MMSE), of American origin (1975), was originally designed to detect cognitive impairment and monitor evolution in patients with neurological disorders, especially dementia.

Although it is widely used in the elderly population, it is also applicable from seven years of age.

Its administration lasts approximately 5 to 10 minutes in healthy patients, time that can be extended if there is deterioration.

It is crucial to take into account the contraindications for its application: it should not be administered if the patient presents depression, anxiety, fever, infections (such as meningitis), is under the effects of drugs or alcohol, or is undergoing a bereavement, since these conditions affect the care and validity of the results.

Assessment Protocol by Areas

The test consists of 30 questions that assess various areas. Orientation is measured in time and space (year, season, place, floor). Fixation (immediate memory) requires the patient to repeat three words (e.g. ball, flag, tree) until they are learned.

Attention and Calculation are evaluated by successive subtractions (100 minus 7) or spelling the word "WORLD" backwards, scoring the best execution of the two tasks.

Recall (delayed recall) asks for recall of the three previously learned words.

Finally, Language and Construction are assessed by naming objects (pencil, watch), repeating sentences, following three-step instructions (take paper, fold it, drop it), reading, writing a sentence, and copying a geometric drawing.

Interpretation of Scores and Impairment

The maximum score is 30 points. According to the standard scale, a score of less than 5 indicates severe dementia; between 6 and 9, moderate to severe dementia; and between 10 and 24, mild to moderate cognitive impairment. Between 25 and 26 points is considered possible impairment.

Although the manual indicates that from 27 to 30 points there is no impairment (allowing up to three errors), clinically it is significant to pay attention to a patient scoring 27 points, as errors could be early indicators of cognitive decline requiring further inquiry.

Summary

The MMSE (1975) is designed to detect cognitive impairment and dementia, being applicable from the age of seven. Its administration lasts up to ten minutes, but is contraindicated if the patient presents depression or anxiety.

It evaluates orientation in time and space, immediate and delayed memory, attention through calculation or spelling, and language. It consists of thirty questions that explore these areas to determine the current mental state.

The maximum score is thirty; values below twenty-four indicate mild to moderate impairment, while less than nine indicate severe dementia. Twenty-seven points already suggest clinical alert for possible early decline.