Mini Mental State Examination

A Mini Mental State Examination is a quick and easy way to assess someone's mental state. Whilst not as thorough as a full mental state examination, it allows a valid assessment in a short time.
1. First, you should explain the process to the patient you are assessing. Say that you are going to be asking them a variety of questions, some of which may seem a bit silly, but that they are to answer them to the best of their ability.
2. Firstly you should assess the patient's orientation in time. For this, ask them to tell you the year, season, date, day and month scoring 1 for each correct answer.
3. Registration is now assessed. This is done by naming three objects and asking the patient to repeat them back to you and remembering them. 1 point is given for each correct answer. After the first attempt repeat the words until the patient learns them. Count the number of times it takes for the patient to learn them.
4. Next attention is checked. There are 2 ways to assess this. Either ask the person to take 7 away from 100 then again from the answer and so on for 5 times. If this poses a problem, ask the patient to spell WORLD backwards. There is a maximum of 5 points available for this task.
5. Recall is assessed by asking the patient to name the three items told to them in step 4.
6. Language is now assessed. Firstly, point to a pencil and a watch and ask the patient to name them, this scores a maximum of 2 marks. Next ask the patient to repeat the saying 'No Ifs Ands or Buts' - 1 mark if done correctly. Next you should hand a piece of paper to the patient and say 'Take this piece of paper in your hand, fold it in half and place it on the floor.' Each stage of this task scores 1 mark if performed correctly giving a maximum of 3. Next, write Close Your Eyes on a piece of paper and show it to the patient and ask them to follow the command. If this is performed they score another mark. Next you should ask the patient to write down any sentence, they score a mark if it is coherent, you are not assessing spelling ability. Finally, you should show them a drawing of two intersecting pentagons like below and ask them to copy the drawing. If this is done successfully they score another point.

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7. The total score should be added up and marked out of 30. A score of 23 or below suggests cognitive impairment.


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