Folstein Mini-Mental Status Examination

In addition, you should perform some objective measure of the patient s intellectual functioning. The most commonly used measure is the Folstein Mini-Mental Status Examination (MMSE). The 30 point MMSE assesses many of the intellectual functions that might be impacted by dementia orientation to surroundings, registration of new information into memory, recall of that same information, concentration, word-finding, following directions, and visuospatial tasks. A score of 25 or lower should raise concern but early dementia is not ruled out even with higher scores. 

Other diagnostic tests to consider for differential diagnosis erythrocyte sedimentation rate, urinalysis, toxicology, chest x-ray, heavy metal screen, HIV testing, cerebrospinal fluid (CSF) examination, electroencephalography, and neuropsychological tests such as the Folstein Mini Mental Status Exam. 

The Mini-Mental Status Examination, developed by Folstein et al. in 1973 (22), is widely used across a variety of populations. It includes 11 questions and requires 5 to 10 minutes to administer. It is divided into two sections, the first of which requires oral responses only and covers orientation, memory, and attention. The second part assesses the ability to name, follow verbal and written commands, write sentences spontaneously, and copy a complex figure. The measure has demonstrated good reliability and validity (22). 

The Mini Mental State Examination (Folstein et ah, 1975) has been adapted and studied for use with children (Ouvrier et ah, 1993 Besson and Labbe, 1997) and other screening tools to assess cognitive function in children have also been developed (Ouvrier et ah, 1999). These tools are invaluable, as so often altered mental status in a child can be related to impaired cognitive function or early delirium. 

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