The Mini-Mental Test for Detecting Possible Dementia

January 23, 2020
The primary detection of dementia is essential for implementing plans that can improve its outlook. The Mini-Mental test is one of the most popular evaluation instruments in this field.

Due to increased longevity in today’s society, the prevalence of Alzheimer’s and related diseases has increased dramatically. As such, it’s important to have good evaluation instruments. These should be able to detect cognitive impairment conditions quickly and easily. The Mini-Mental is one of the tests experts use the most for this task.

Early detection of this disease is very important for being able to implement treatments that improve its outlook. Both primary care physicians and specialists should also have access to such tests. This is especially true given the fact that doctors don’t identify about 70% of these cases correctly.

An elderly woman looking out the window.

The Mini-Mental test

The Mini-Mental State Examination (MMSE) evaluates cognitive changes. Its aim in doing this is to detect possible cases of dementia. This is a screening instrument. That means that it’s the initial search in a more involved process. If it brings up a cause for suspicion, the physician should follow it up with a more exhaustive test. Depending on the number of points the subject obtained, it can discern between different types of cognitive functions. These types are normal cognitive functioning or mild, moderate, or severe dementia.

You also have to keep in mind that cognitive decline can be a benign and normal occurrence. Mild cognitive decline associated with age is normal. But there’s a difference between this and dementia. The main difference is that the former only affects memory. The latter condition, on the other hand, causes multiple problems and compromises the person’s ability to continue with their daily lifestyle.

In order to discover this situation, the Mini-Mental test evaluates, by means of its questions, the different cognitive areas that might be affected. Before starting, the person doing the testing explains that they’re going to ask the subject some questions. Then, they tell them that they’re going to ask them to undertake some tasks. After making sure that the subject has the appropriate glasses and headphones on to reduce any sensory deficit, the test begins.

Cognitive areas the Mini-Mental test evaluates

Orientation

In order to evaluate temporal orientation, the physician asks the person: What day of the week is it today? Can you tell me what month it is? What’s today’s date? The year? What season are we in now?

In order to evaluate spatial orientation, the doctor asks: where are we? On what floor are we? What street are we on? In what city? What country is this?

Fixation

This test attempts to measure the retentive capacity of the individual. In order to do that, the physician has to explain to them that they’re going to tell them three words. The doctor will then repeat those three words. The patient should then try to remember them because the doctor might ask them about the words later. For example, the doctor might ask them to repeat the words “dime”, “horse”, and “apple”. They get one point for each correct repetition.

Concentration and calculative ability

  • In this test, the physician asks the individual to count down from 30 by intervals of three.
  • After that, the physician asks the subject to repeat the sequence 5-9-2. They have to do this until they learn it. Afterwards, they should be asked to say it in reverse.

Memory

For this part, the physician asks the subject if they remember the three words they told them before in the fixation test. The doctor then gives them one point for each word they remember regardless of the order.

A person completing a head jigsaw puzzle that isn't a part of the mini-mental test.

Language and construction

  • The medical professional then shows the subject a watch and a pen and asks them to identify the objects.
  • The doctor then asks them to repeat the phrase “There were five dogs in a cornfield”.
  • They’re then asked, “Apples and pears are fruits. So what are cats and dogs? And red and green?”
  • After that, the patient is instructed to take a paper in their right hand. They then have to fold it and place it on the table. The physician notes whether or not they can complete this task.
  • The doctor then gives the patient a sheet of paper with “close your eyes” written on it. Then, they ask the patient to read it and do as it says.
  • Afterwards, the subject is asked to write a sentence with a subject and a predicate.
  • Another task in this test is where the doctor shows the subject a drawing then asks them to copy it onto another piece of paper.

Use of the Mini-Mental test

Depending on the performance on each of the tests, the physician can get some valuable insight into the patient’s state. The different points tell them whether the person is suffering from some level of dementia. As we’ve shown in this article, this test is relatively fast and easy to use.

It’s perfect as a screening method, but it’s always going to be necessary to finish the diagnostic process. This requires a more exhaustive evaluation. Nevertheless, its simplicity and its ability to discern problems easily make it a very popular test. It’s one of the most broadly used evaluations for measuring cognitive function and detecting dementia.

  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of psychiatric research12(3), 189-198.
  • Allegri, R. F., Ollari, J. A., Mangone, C. A., Arizaga, R. L., De Pascale, A., Pellegrini, M., … & Candal, A. (1999). El “Mini Mental State Examination” en la Argentina: instrucciones para su administración. Revista Neurológica Argentina24(1), 31-35.