Mini-Mental State Examination (MMSE)

 

Mini-Mental State Examination (MMSE) Evaluation Summary

  What does the tool measure? Cognitive impairment
  What types of clients can the tool be used for? While originally used to detect dementia within a psychiatric setting, its use is now widespread and is available with an attached table that enables patient-specific norms.
  Is this a screening or assessment tool? Screening
Time to administer Administration by a trained interviewer takes approximately 10 minutes.
  Versions The modified mini-mental state examination (3MS); 3MS + Clock-drawing; Standardized MMSE (SMMSE); Telephone version (ALFI-MMSE); 26-item version of the ALFI-MMSE (T-MMSE)
Other Languages Afrikaans; Dutch; Romanian; Arabic; Estonian; Italian; Russian; Argentinean Spanish; Filipino; Japanese; Russian for Estonia; Belgian Dutch; Finnish; Kannada; Serbian; Belgian French; French; Korean; Slovakian; Bosnian; Austrian German; Latvian; Brazilian; Portuguese; German; Lithuanian; Spanish; Bulgarian; Greek; Macedonian; Swedish; Chilean Spanish; Gujarati; Malayalam; Telugu; Chinese; Hebrew; Marathi; Turkish; Croatian; Hindi; Norwegian; Czech; Hungarian; Polish; Ukranian; Danish; Portuguese; Urdu
Measurement Properties
  Reliability

– Out of 9 studies examining the internal consistency of the MMSE, 3 reported  poor  internal consistency, 1 reported adequate  internal consistency, 2 reported poor  to excellent  internal consistency, 2 reported excellent  internal consistency, 1 reported excellent internal consistency in patients with Alzheimer’s Disease and poor  internal consistency in patients with cognitive impairment.
– Out of 6 studies examining the test-rest reliability of the MMSE, 2 studies reported excellent  test-rest, 1 reported adequate  test-retest, 1 reported adequate  to excellent  test-retest, 1 reported poor  to adequate  test-rest, 1 reported poor  test-retest.
– Out of 3 studies examining the inter-rater reliability of the MMSE, 1 reported excellent  inter-rater, 2 reported adequate  inter-rater.

  Validity

Criterion:
The MMSE can discriminate between patients with Alzheimer’s Disease and frontotemporal dementia; can discriminate between patients with left- and right-hemispheric stroke. 

Construct:
Concurrent:
MMSE had a  poor correlation with the Mattis Dementia Rating Scale; poor  to excellent correlations with the Wechsler Adult Intelligence Test; adequate correlation with the Functional Independence Measure ; significant correlations with the Montgomery Asberg Depression Rating Scale and the Zung Depression Scale. 

Predictive: 
MMSE scores found to be predictive of functional improvement in patients with stroke following rehabilitation; discharge destination; developing functional dependence at a 3-year follow-up interval; ambulatory level; length of hospital stay such that for patients with moderate dementia; death. 

Floor/Ceiling effects: 
Folstein, Folsten, and McHugh (1998) reported that the MMSE demonstrates marked ceiling effects in younger intact individuals and marked floor effects in individuals with moderate to severe cognitive impairment.

  Does the tool detect change in patients? Not applicable.
  Acceptability The MMSE is a brief measure to administer. Patient variables such as age, level of education and sociocultural backgroup may affect scores on the measure. It is administered by direct observation and is therefore not appropriate for proxy use.
Feasibility No specialized equipment is required, and therefore it is a highly portable and inexpensive measure. However, one study reported that physicians found the MMSE too lengthy and unable to contribute much useful information.
How to obtain the tool? The MMSE can be obtained from the current copyright owner, Psychological Assessment Resources (PAR).