Mini–mental state examination

The Mini -Mental State Examination ( MMSE Abbr ) was developed in 1975 by Folstein and colleagues to provide a suitable for clinical routine screening method for detection of cognitive deficits. Since its introduction into clinical practice it has proven to be a reliable tool for initial assessment of a patient as well as for follow-up. Thus it is now the most frequently used tool in the diagnosis of dementia and Alzheimer's disease.

The MMSE is often referred to as the Folstein test, also consistently is the abbreviation Mini-Mental or the English name of Mini - Mental State Examination ( MMSE).

Test sequence

Implementation

The Mini -Mental State Examination is conducted as an interview with the patient. Central cognitive functions are checked based on 9 task complexes ( temporal and spatial orientation, memory and memory ability, attention, language and speech understanding, as well as reading, writing, drawing and arithmetic). The implementation usually takes about 10 minutes.

The tasks of the MMSE include both answering questions and performing simple actions (eg, " What year is it? " Repetition, fold sheet of paper and place it on the floor). The following points should be observed when carrying out essential in order to avoid distortions of the result:

Evaluation

For each task successfully managed the patient gets a point. The points are added up after the test. The scale ranges from 0 to 30 points, where 30 stands for unlimited, 0 for worst possible damaged cognitive functions.

From values ​​below 25 points there is a krankheitswertige impairment. A score below 20 indicates a mild to moderate dementia, a severe form is a score of below 10 against.

The test evaluation is only a few minutes.

Review and Critique

The Mini -Mental State Examination is a highly economical and very easy to perform method for rapid screening of dementia, which two of the three central dementia diagnostic criteria recorded ( memory impairment, impairment of at least one other cognitive function). In its application, however, the extreme sensitivity of the test is to be considered for interference (see above). In addition, the MMSE provides only a rough estimate of cognitive deficits, which must be supported and verifies if there is a critical value by another test method. In addition, it is not an instrument for the early detection of dementia and does not help in distinguishing the various forms of dementia ( Alzheimer's, vascular, frontal dementia).

In addition to the neurodegenerative changes in the brain of dementia and depression can lead to some significant limitations in cognitive functions. If the MMSE so positive, careful diagnostic differentiation from depression ( and in particular for the age depression) is unavoidable.

Nevertheless, the Mini-Mental State Examination is an efficient method of screening of suspected dementing disorders and " his commitment to a waiver of any testing preferable " ( Berger, p 303). In addition, it lends itself very well to dementing disorders to monitor the progress and if necessary to verify the success of therapeutic measures ( follow-up ).

Other methods

• Other screening methods: DemTect ( especially for early detection; Kessler et al, 2000. ), clock drawing test, test for early detection of dementia with depression boundary ( TFDD; Ihl, R. & Grass - Kapanke, B., 2000)
• Clinical Dementia Rating ( CDR) procedures for the collection of the severity of dementia, particularly the " non-cognitive " impairments (Berg, 1984)
• Functional Assessment Staging (FAST), simpler severity assessment in early and late stages of dementia ( Reisberg, 1988)