The Mini-Mental State Examination (MMSE) score is calculated by administering a structured set of questions and tasks that assess various cognitive functions, with each correct response earning a specific number of points. The total score ranges from 0 to 30 points, with higher scores indicating better cognitive function.
The MMSE is divided into several sections, each targeting a different cognitive domain:
1. **Orientation**
This section evaluates awareness of time and place. The patient is asked questions such as the current date, day of the week, season, and their location (e.g., city, building). Each correct answer earns points, typically up to 10 points in total for orientation.
2. **Registration (Immediate Memory)**
The examiner names three unrelated objects clearly and asks the patient to repeat them immediately. Each correctly repeated word scores one point, for a total of 3 points.
3. **Attention and Calculation**
This part tests concentration and working memory. Common tasks include serial subtraction (e.g., subtracting 7 from 100 repeatedly) or spelling a word backward. Each correct step or letter earns points, usually up to 5 points.
4. **Recall (Short-term Memory)**
After a brief delay, the patient is asked to recall the three objects named earlier in the registration section. Each correctly recalled word scores one point, up to 3 points.
5. **Language**
This section assesses several language abilities:
– Naming two common objects (e.g., a pencil and a watch)
– Repeating a phrase exactly as said by the examiner
– Following a three-stage command (e.g., “Take a paper in your right hand, fold it, and put it on the floor”)
– Reading and obeying a written command (e.g., “Close your eyes”)
– Writing a sentence spontaneously
Each task has assigned points, totaling around 8 points.
6. **Visuospatial Skills**
The patient is asked to copy a simple geometric figure, such as two intersecting pentagons. Successful copying earns 1 or 2 points.
The examiner scores each item according to the patient’s responses. The sum of all points from these sections gives the final MMSE score, which can range from 0 (severe cognitive impairment) to 30 (normal cognition).
Interpretation of the MMSE score generally follows these guidelines:
– **24 to 30 points:** Normal cognition or no cognitive impairment
– **18 to 23 points:** Mild cognitive impairment
– **12 to 17 points:** Moderate cognitive impairment
– **0 to 11 points:** Severe cognitive impairment
The MMSE is designed to be a quick screening tool, typically taking about 5 to 10 minutes to administer. It is widely used in clinical settings to detect cognitive deficits, monitor changes over time, and assist in diagnosing conditions like dementia.
The scoring is straightforward: each correct answer or task completion adds to the total score. The examiner must carefully follow the standardized instructions to ensure consistent scoring. Some variations or modifications of the MMSE exist, but the core scoring principle remains the same—adding points for correct responses across the cognitive domains tested.
In practice, the MMSE score helps clinicians understand the severity of cognitive impairment and guides further diagnostic and treatment decisions. It is important to consider factors such as the patient’s education level, language, and cultural background when interpreting the score, as these can influence performance.
