The Mini Mental State Examination (Mmse) - Mount Sinai Hospital printable pdf download

Issue Number 3, January 1999

Series Editor: Meredith Wallace, PhD, RN, MSN, CS

The Mini Mental State Examination (MMSE)

By: Lenore Kurlowicz, PhD, RN, CS and Meredith Wallace, PhD, RN, MSN

WHY: Cognitive impairment is no longer considered a normal and inevitable change of aging. Although

older adults are at higher risk than the rest of the population, changes in cognitive function often call for

prompt and aggressive action. In older patients, cognitive functioning is especially likely to decline during

illness or injury. The nurses’ assessment of an older adult’s cognitive status is instrumental in identifying

early changes in physiological status, ability to learn, and evaluating responses to treatment.

BEST TOOL: The Mini Mental State Examination (MMSE) is a tool that can be used to systematically and

thoroughly assess mental status. It is an 11-question measure that tests ﬁve areas of cognitive function:

orientation, registration, attention and calculation, recall, and language. The maximum score is 30. A score

of 23 or lower is indicative of cognitive impairment. The MMSE takes only 5-10 minutes to administer and

is therefore practical to use repeatedly and routinely.

TARGET POPULATION: The MMSE is effective as a screening tool for cognitive impairment with older,

community dwelling, hospitalized and institutionalized adults. Assessment of an older adult’s cognitive

function is best achieved when it is done routinely, systematically and thoroughly.

VALIDITY/RELIABILITY: Since its creation in 1975, the MMSE has been validated and extensively used in

both clinical practice and research.

STRENGTHS AND LIMITATIONS: The MMSE is effective as a screening instrument to separate patients

with cognitive impairment from those without it. In addition, when used repeatedly the instrument is able to

measure changes in cognitive status that may beneﬁt from intervention. However, the tool is not able to

diagnose the case for changes in cognitive function and should not replace a complete clinical assessment of

mental status. In addition, the instrument relies heavily on verbal response and reading and writing. Therefore,

patients that are hearing and visually impaired, intubated, have low English literacy, or those with other

communication disorders may perform poorly even when cognitively intact.

The Mini Mental State Examination (Mmse) - Mount Sinai Hospital