What happens during the MMSE test?

If you or a loved one have been asked to do a mini mental state examination (MMSE) you might be feeling worried or stressed. But the test itself is quite short and straightforward. Find out what you need to know about it

In a nutshell

If you’re worried about your memory and you go to see a doctor, he will probably suggest you do a mini mental state examination, which, despite having a long and rather scary name, simply means he will ask you a few questions which are designed to reveal any particular memory issues you might be having. The whole ‘test’ takes around ten minutes.

Good to know

Understandably perhaps, many people still feel quite anxious about having a MMSE. If you, or someone you know, is about to have one (or has just had one) try to ease anxieties by remembering that the mini mental state examination is NOT:

- An ‘exam’ or ‘test’ which you can pass or fail
- An intelligence test
- A test which proves you have dementia

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What are the questions?

The questions themselves are quite simple. For example, you could be asked what the date is, how to spell a simple word (such as ‘world’ or ‘house’) or you might be asked to remember three words, then repeat them back a few minutes later. Sometimes you can be asked to draw a picture – maybe of a house, a clock or a face.

Why?
The questions may seem a bit random and odd but they’re actually quite carefully constructed to assess different areas of brain function such as orientation (date, time year) or recall. The drawing tasks assess visual-spatial skills, planning and organisation.

Did you know? Some evidence suggests that drawing a clock (you might also be asked to include numbers and a time such as ‘ten minutes after eleven’) is an excellent measure of certain types of brain functions associated with dementia.

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How you are scored and what it means

The mini mental health state examination is scored out of 30.
A score of
- 27-30 usually means your memory is normal
- 10-26 could indicate mild to moderate dementia
Less than 10 suggests you may have quite severe symptoms of dementia

BUT

It’s important to remember that whatever your score it doesn’t mean you definitely have – or haven’t – got Alzheimer’s or any other kind of dementia. The MMSE is only one part of the diagnosis journey. Whilst it can be effective, it can’t always detect subtle memory losses and isn’t 100 per cent accurate.

For example, the MMSE doesn’t take into account

  • Education – people who are highly educated tend to do better in the MMSE than those who aren’t, regardless of whether they have dementia or not. So a high score could be misleading.
  • Cultural differences – if English isn’t your first language or you aren’t familiar with certain areas of British life (sometimes you can be asked questions such as ‘who is the current Queen of England?’) your score may suggest a higher degree of difficulty than you actually have.

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The good news

Whether it’s carried out in your doctor’s surgery, at a specialist memory clinic or in a hospital, the MMSE has considerable benefits when it comes to working out your care plan. For example, you could find that you’re entitled to certain drug treatments which might slow down the progress of your condition.

For example

  • A score of 10-26 usually means you could be offered a drug called donepezil (you might know it as Aricept), or rivastigmine (Exelon) or galantime (Reminyl).
  • A lower score could mean you’re entitled to a drug called memantine (Exiba).

What happens now?

If you have dementia, the MMSE can also be used to check how you’re doing. So don’t worry if your doctor or specialists want you to do another test in a few months’ time or a couple of years down the line. If your score has changed, it’s better to know because they might then be able to suggest different treatments which could be more effective, and help you to continue living well and enjoying life.

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