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Journal ArticleDOI

“Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician

TL;DR: A simplified, scored form of the cognitive mental status examination, the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
About: This article is published in Journal of Psychiatric Research.The article was published on 1975-11-01. It has received 76181 citations till now. The article focuses on the topics: Cognitive decline & Cognitive Intervention.
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Journal ArticleDOI
TL;DR: This study evaluated a modified, timed version of the “Get‐Up and Go” Test (Mathias et al, 1986) in 60 patients referred to a Geriatric Day Hospital and suggested that the timed “Up & Go’ test is a reliable and valid test for quantifying functional mobility that may also be useful in following clinical change over time.
Abstract: This study evaluated a modified, timed version of the "Get-Up and Go" Test (Mathias et al, 1986) in 60 patients referred to a Geriatric Day Hospital (mean age 79.5 years). The patient is observed and timed while he rises from an arm chair, walks 3 meters, turns, walks back, and sits down again. The results indicate that the time score is (1) reliable (inter-rater and intra-rater); (2) correlates well with log-transformed scores on the Berg Balance Scale (r = -0.81), gait speed (r = -0.61) and Barthel Index of ADL (r = -0.78); and (3) appears to predict the patient's ability to go outside alone safely. These data suggest that the timed "Up & Go" test is a reliable and valid test for quantifying functional mobility that may also be useful in following clinical change over time. The test is quick, requires no special equipment or training, and is easily included as part of the routine medical examination.

12,004 citations

Journal ArticleDOI
TL;DR: Patients who meet the criteria for MCI can be differentiated from healthy control subjects and those with very mild AD, and appear to constitute a clinical entity that can be characterized for treatment interventions.
Abstract: Background Subjects with a mild cognitive impairment (MCI) have a memory impairment beyond that expected for age and education yet are not demented. These subjects are becoming the focus of many prediction studies and early intervention trials. Objective To characterize clinically subjects with MCI cross-sectionally and longitudinally. Design A prospective, longitudinal inception cohort. Setting General community clinic. Participants A sample of 76 consecutively evaluated subjects with MCI were compared with 234 healthy control subjects and 106 patients with mild Alzheimer disease (AD), all from a community setting as part of the Mayo Clinic Alzheimer's Disease Center/Alzheimer's Disease Patient Registry, Rochester, Minn. Main Outcome Measures The 3 groups of individuals were compared on demographic factors and measures of cognitive function including the Mini-Mental State Examination, Wechsler Adult Intelligence Scale–Revised, Wechsler Memory Scale–Revised, Dementia Rating Scale, Free and Cued Selective Reminding Test, and Auditory Verbal Learning Test. Clinical classifications of dementia and AD were determined according to the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition and the National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer's Disease and Related Disorders Association criteria, respectively. Results The primary distinction between control subjects and subjects with MCI was in the area of memory, while other cognitive functions were comparable. However, when the subjects with MCI were compared with the patients with very mild AD, memory performance was similar, but patients with AD were more impaired in other cognitive domains as well. Longitudinal performance demonstrated that the subjects with MCI declined at a rate greater than that of the controls but less rapidly than the patients with mild AD. Conclusions Patients who meet the criteria for MCI can be differentiated from healthy control subjects and those with very mild AD. They appear to constitute a clinical entity that can be characterized for treatment interventions.

8,255 citations

Journal ArticleDOI
TL;DR: ACCF/AHAIAI: angiotensin-converting enzyme inhibitor as discussed by the authors, angio-catabolizing enzyme inhibitor inhibitor inhibitor (ACS inhibitor) is a drug that is used to prevent atrial fibrillation.
Abstract: ACC/AHA : American College of Cardiology/American Heart Association ACCF/AHA : American College of Cardiology Foundation/American Heart Association ACE : angiotensin-converting enzyme ACEI : angiotensin-converting enzyme inhibitor ACS : acute coronary syndrome AF : atrial fibrillation

7,489 citations

Journal ArticleDOI
TL;DR: The Clinical Dementia Rating (CRD) was developed for a prospective study of mild senile dementia—Alzheimer type (SDAT), and was found to distinguish unambiguously among older subjects with a wide range of cognitive function.
Abstract: Accurate clinical staging of dementia in older subjects has not previously been achieved despite the use of such methods as psychometric testing, behavioural rating, and various combinations of simpler psychometric and behavioural evaluations The Clinical Dementia Rating (CRD), a global rating device, was developed for a prospective study of mild senile dementia--Alzheimer type (SDAT) Reliability, validity, and correlational data are discussed The CRD was found to distinguish unambiguously among older subjects with a wide range of cognitive function, from healthy to severely impaired

6,428 citations

Journal ArticleDOI
TL;DR: The purpose of this paper is to provide a comprehensive review of information accumulated over the past 26 years regarding the psychometric properties and utility of the Mini‐Mental State Examination (MMSE).
Abstract: Objective The purpose of this paper is to provide a comprehensive review of information accumulated over the past 26 years regarding the psychometric properties and utility of the Mini-Mental State Examination (MMSE). Participants The reviewed studies assessed a wide variety of subjects, ranging from cognitively intact community residents to those with severe cognitive impairment associated with various types of dementing illnesses. Main Outcome Measures The validity of the MMSE was compared against a variety of gold standards, including DSM-III-R and NINCDS-ADRDA criteria, clinical diagnoses, Activities of Daily Living measures, and other tests that putatively identify and measure cognitive impairment. Results Reliability and construct validity were judged to be satisfactory. Measures of criterion validity showed high levels of sensitivity for moderate-to-severe cognitive impairment and lower levels for mild degrees of impairment. Content analyses revealed the MMSE was highly verbal, and not all items were equally sensitive to cognitive impairment. Items measuring language were judged to be relatively easy and lacked utility for identifying mild language deficits. Overall, MMSE scores were affected by age, education, and cultural background, but not gender. Conclusions In general, the MMSE fulfilled its original goal of providing a brief screening test that quantitatively assesses the severity of cognitive impairment and documents cognitive changes occurring over time. The MMSE should not, by itself, be used as a diagnostic tool to identify dementia. Suggestions for the clinical use of the MMSE are made.

4,469 citations


Cites methods from "“Mini-mental state”: A practical me..."

  • ...which are scored in one of the following ways: (1) the higher of the two scores is used 2,16,19,21,29-33; (2) the two scores are combined21,30r34r35 or (3) each task is analyzed separately....

    [...]

  • ...(1) The MMSE should be used as a screening device for cognitive impairment or a diagnostic adjunct in which a low score indicates the need for further evaluation....

    [...]

References
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Book
01 Jan 1965

84 citations

Journal ArticleDOI
TL;DR: Three parallel forms of the clinical tests of the sensorium were devised, tried out and modified on two groups of 24 subjects and correlated moderately well when repeated.
Abstract: Three parallel forms of the clinical tests of the sensorium were devised, tried out and modified on two groups of 24 subjects. The final versions were further assessed by using each form in turn with 108 psychiatric patients. The three forms of tests gave scores with very similar means and standard deviations. They correlated moderately well when repeated.

57 citations

Journal ArticleDOI
TL;DR: The present paper has attempted to attack the problem of differential “memory function” by examining the discriminating power of certain test results as between “functional”, “doubtful” and “organic” groups of elderly patients, showing that the best discrimination between the groups is achieved by a simple perceptual task.
Abstract: 1. The aim of the research is to examine the relationship of certain aspects of mental functioning to the psychiatric illnesses of old age. The present paper has attempted to attack the problem of differential “memory function” by examining the discriminating power of certain test results as between “functional”, “doubtful” and “organic” groups of elderly patients. 2. The design of the present study shows that spuriously positive results may arise from inadequate control over factors contributing to the selection of the criterion groups. 3. The investigation fails to confirm, for the patients tested, the diagnostic usefulness of certain tests in common use. 4. The results fail to confirm the predictions of “Ribot's Law” as applied to memory in these elderly patients. 5. The study shows significant differences between the means of the results of the psychiatric groups on some tasks which appear to involve “memory function”. These differences cannot be accounted for merely in terms of group differences in general intelligence. The nature of the possible underlying “memory function” remains to be further examined. 6. The investigation so far shows that the best discrimination between the groups is achieved by a simple perceptual task (Bender Gestalt). 7. The study fails to show differences between groups on any of the tests which are sufficiently great to enable these tests to be immediately employed as useful diagnostic instruments.

55 citations

Journal ArticleDOI
TL;DR: It is shown that tests for senility should be short, especially those with oral questions, because of straying attention, impaired comprehension, and short retention, andPerseveration is greatly increased in senescence; it can be brought out merely by having a succession of short, varied items.
Abstract: A tentative battery of 25 short tests for the measurement of senescence is described ( cf. Table I). The scale is the result of the application of nearly 80 tests to senile patients in three London hospitals. It was administered in full to 38 patients in all, and the present findings refer to a group of 20 less seriously demented ones, with an age range of 68 to 83. The tests are classified into three groups according to the degree of difficulty experienced by the seniles (Table II). The divisions were made on the basis of a number of criteria which emerged during the working up of the results, and are only pointers to the kind of functions involved. Briefly, the most difficult tests were those in which subjects were required to break away from old mental habits and adapt to unfamiliar situations, tests of recent memory (logical), of judgment, planning, and reasoning, or embodying difficult or lengthy instructions. Less difficulty was found with such tests as rote memory, fluency of associations, simple arithmetic, and vocabulary. Performance seemed to be least affected on tests of visual recognition, old mental habits, and simple motor tasks. It is shown that tests for senility should be short, especially those with oral questions, because of straying attention, impaired comprehension, and short retention. Perseveration is greatly increased in senescence; it can be brought out merely by having a succession of short, varied items. There is a loss of steadiness and speed on the motor side. The disturbing effect of tests with a time element on the slower acting senile is noted. The present mental status of the patients is estimated on eleven tests which are scored on the (outmoded) mental age method (Table I): the average of these is between M.A. 10 and 11. This figure is compared with previous reports on the decline of intelligence. An estimate of the former mental status of each patient is made by means of efficiency quotients on part of the “Bellevue” scale. These relate each score to the average level for the peak age-group of 20 to 24 years (Table III). The use of the vocabulary score as an index of former level is discussed. A comparison of score variation within individuals with variation between individuals shows a ratio of the former to the latter of approximately 85 per cent. Variability of scores within individuals increases with age inside the patient group, also with lower intelligence. A shortened version of the scale, which takes about 40 minutes, is indicated (Table I).

19 citations