What is a Mini-Mental State Examination (MMSE)?

A Mini-Mental State Examination (MMSE) is a set of 11 questions that doctors and other healthcare professionals commonly use to check for cognitive impairment (problems with thinking, communication, understanding and memory).

What is a MMSE used for?

Your doctor might perform the MMSE if there is a reason to suspect you may be confused, such as after a head injury or during a sudden episode of illness such as an infection. It is also sometimes used as part of the process for determining if someone has cognitive impairment, such as dementia.

The test used in Australia is known as the SMMSE (Standardised Mini-Mental State Examination).

What abilities does the MMSE check?

The MMSE can be used to assess 6 areas of mental abilities, including:

• orientation to time and place — knowing the date and where you are
• attention / concentration
• short-term memory (recall)
• language skills
• visuospatial abilities — visual and spatial relationships between objects
• ability to understand and follow instructions

What does the MMSE involve?

The MMSE test consists of a series of tasks such as:

• memorising a few objects and then repeating the list back later
• copying a drawing
• writing a short sentence that is grammatically correct, such as “The dog sat on the floor”
• correctly identifying the current day of the week, followed by the date, the month, the season and the year
• correctly identifying where you are

The test takes about 5 to 10 minutes. The questions are usually the same (or very similar) regardless of who conducts the test.

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How is the MMSE scored?

The maximum score for the MMSE is 30. A score of 25 or higher is classed as normal. If the score is below 24, the result is usually considered to be abnormal, indicating possible cognitive impairment.

What are the limitations of the MMSE?

There are limitations to the MMSE which means that your doctor or healthcare professional will take care when interpreting the results.

A high MMSE score does not necessarily mean that you don’t have cognitive impairment. Similarly, a low score does not necessarily mean that you have dementia. Sometimes, certain physical disabilities, language, speech, education level or cultural differences can affect the score.

For example, a highly educated person with dementia might still score highly, especially early in their disease.

Your doctor will take this into account when interpreting the results and they will advise if they think you should have further tests or assessments. An MMSE is just one part of a diagnosis of cognitive impairment or dementia.

Why might I be asked to repeat the test?

The MMSE may be repeated to check for changes in cognition over time. A deterioration in your MMSE score might prompt your doctor or healthcare provider to ask more questions or arrange other tests.

In someone who has already been diagnosed with dementia, a repeat MMSE test may show how quickly their dementia is progressing.

If you are feeling anxious about the MMSE

Despite its name, the MMSE is a straightforward short questionnaire. It is important to know:

• you do not need to ‘prepare’ or ‘study’ for the test
• you cannot ‘pass’ or ‘fail’
• it is not an IQ or intelligence test
• in isolation, it will not diagnose you with any disease, such as dementia