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Dementia | World Spelled Backwards: The Mini-Me . . .
"World" Spelled Backwards: The Mini-Mental State Exam
If you have ever accompanied an older person to the doctor you may have seen the Mini-Mental State Exam (MMSE) administered. You may have even experienced it yourself. Most doctors like to use this test because it is quick (ten or eleven minutes usually), non-invasive, and easy.
The MMSE is a screening tool that professionals use to evaluate cognitive ability. Many people think of it as the "Alzheimer's test," but in reality a multitude of things including medications and infections can cause cognitive changes.
A low score on the Mini Mental State Exam does not give the doctor or the clinician a diagnosis. It is an indicator that further investigation into the reasons for the low score is needed. Do not ever accept a diagnosis of Alzheimer's Disease simply because a loved one has scored poorly on the MMSE.
Even after a diagnosis has been determined, many doctors like to continue giving the MMSE on a regular basis so that they can track changes over time.
The actual test itself is copyrighted, so we won't be posting it here. However, in general this is how it works...
How The Mini Mental State Exam Works
There are 30 possible correct answers. These are divided into five general areas of "memory" and "cognition."
1. "Orientation": Does the person being tested have an awareness of time and place? This is where the tester asks the questions about the date, the season or time of year, and the location.
2. "Registration": Can the subject find the words to name or identify objects, and can the subject memorize a list of three things?
3. "Attention": Is the subject able to count backwards by 7s, or can the subject spell a word backwards (the preferred word to spell backwards is "world")?
4. "Recall": Can the subject remember and repeat the three items that were memorized earlier?
5. "Language": Can the subject write a sentence, follow a simple written command, and copy a specific design?
The MMSE score is adjusted to accommodate for any disabilities or inabilities that might affect the results. For instance, lack of fluency in the language, hearing or visual problems, learning disabilities or the inability to read, or physical problems that make writing or drawing difficult are all taken into account by an experienced tester. Scores should also be adjusted for those who have had little formal education.
Mini Mental State scores are usually written as the number of correct answers over the number of possible correct answers. A perfect score would be written as 30/30. Those with a score of 26/30 or lower should certainly be evaluated more closely. Just remember, though, that anyone could be having a bad day, and missing two or three items on an MMSE is no cause for panic.