09 February 2009

The Mini Mental State Exam for Diagnosing Alzheimer's

The MMSE is the most commonly used test toward diagnosing Alzheimer's. It's a list of questions that is scored. Although it appears to be a simple test, only trained clinicians should give and score it.

The MMSE asks questions that assess five areas:

Orientation - What is the year? What is the season? What is the date? What is the day? What is the month? What state are we in? What county are we in? What town are we in? What (hospital, or other building) are we in? What floor are we on?

Short-Term Memory - The doctor names three objectsand asks the person to repeat the three words all at once. A a maximum of six tries is permitted.

Attention - The person is asked to count backwards from 100 by 7s, or to spell the word “world” backwards.

Short-Term Memory - The person is asked to repeat the three objects named earlier

Language - First, the doctor holds up a pencil and a watch,separately, and then asks the person to name the objects. Next, the person is asked to repeat the phrase, "No ifs, ands, or buts." Third, the person is asked to follow a three-stage command. Fourth, the person is given a piece of paper with the command "Close your eyes" written on it and is asked to do what the paper says. Fifth, the person is asked to write a unique sentence. Sixth, the person is asked to copy a simple design.

The maximum score on the MMSE is 30. In general, scores fall into four categories:
24 – 30 is "normal, " 20 – 23 points is mild cognitive impairment or possible early-stage/mild Alzheimer's, 10 – 19 points is middle-stage/moderate Alzheimer's and 0– 9 is late-stage/severe Alzheimer's disease.

This MMSE shouldn't be used all by itself to make a diagnosis. A diagnosis of Alzheimer's can only be made after a complete diagnostic workup rules out any other possible cause for the person's symptoms. Many other things need to be looked at.

Click HERE for a listing of various tests the doctors will conduct to diagnose Alzheimer's.


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