Mental state examination cognition

Jonsson L, Lindgren P, Wimo A, Jonsson B, Winblad B (1999a). Costs of Mini Mental State Examination — related cognitive impairment. Pharmaeoeconomics 16, 409—16. 

The Folstein Mini-Mental State Examination (MMSE) can help to establish a history of deficits in two or more areas of cognition and establish a baseline against which to evaluate change in severity. The average expected decline in an untreated patient is 2 to 4 points per year. 

Elderly patients after admission to a hospital often first show mental signs and symptoms, then show behavioural disturbances (Saravay et al. 2004). Thus if early mental signs and symptoms are identified and acted on, behavioural disturbances and subsequent extended length of hospital stay may be prevented. For cognitive testing many screening instruments are available. The most widely used is probably Mini Mental State Examination (MMSE). 

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. 

For measurement of cognitive outcomes in Alzheimer s disease, the MMSE (Mini Mental State Examination) instrument, scored out of 30 (best), is used. Mild Alzheimer s disease is usually associated with an MMSE of 21-26. Moderate Alzheimer s disease is usually associated with an MMSE of 10-20 (NICE, 2006). 

The severity of cognitive deficits in patients suffering from, or suspected of having, dementia can be quantified by a simple 30-point schedule, the mini mental-state examination (MMSE) of Folstein. A score of 21-26 denotes mild, 10-20 moderate and less than 12 severe Alzheimer s disease. The MMSE can also be used to monitor progress. 

I Mini-Mental State Examination (MMSE) screening instrument briefly tests several areas of cognition but not in depth. Score 0 (low performance) to 30 (high performance). 

The Mini Mental State Examination (MMSE) (Folstein et al., 1975). The MMSE screens for cognitive impairment scores greater than or equal to 26 points (out of 30) indicate normal cognition. Below this, scores can indicate severe (<15 points), moderate (16-19 points) or slight (20-25 points) cognitive impairment. 

The disease invariably worsens with time but with wide interindividual variability. Generally, cognitive impairment as measured on the Mini-Mental State Examination (MMSE) declines by 3 to 4 points per year. In slow de-cliners, however, loss may be less than 1 point per year and, in fast decliners loss may be as much as 7 points or more per year. In addition, mental decline usually follows a linear pattern or shows temporary plateaux between periods of more or less rapid decline. Performance also varies from one day to the next and occasionally within a given day. Nevertheless, major long-... 

An 80-year-old man with Parkinson s disease treated with levodopa/carbidopa (100/25 mg) three times daily developed nausea, insomnia and auditory hallucinations 2 days after being commenced on citalopram lOmg per day. He had metastatic prostatic carcinoma, gastro-oesophageal reflux and chronic cellulitis but no cognitive impairment (a Mini Mental State Examination (MMSE) score of 29/30). There were no features consistent with delirium the auditory hallucinations stopped within 48 h of cessation of citalopram [35 ]. 

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