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

A Mini-Mental State Examination (MMSE) is a set of 11 questions. It's used by doctors and other health professionals to check for cognitive impairment.

It's used to see if you have problems with your thinking or communication. It can check for problems with understanding and amnesia (memory).

What is a MMSE used for?

Your doctor might use the MMSE if you seem confused. This could be after a head injury or during a sudden illness to see if your brain is affected.

The MMSE is also used to see if people have a cognitive impairment, such as dementia.

Cognitive impairment is when you have problems with your mental ability. You might have trouble remembering things. You might also have trouble learning new things or concentrating. Sometimes it affects how you make decisions that affect your daily life.

Cognitive impairment is a common problem as people age. It can affect anyone. Having the test is important for your safety.

The test for cognitive impairment used in Australia is called the SMMSE. This stands for Standardised Mini-Mental State Examination.

What does the MMSE check?

The MMSE checks 6 areas of mental ability. These include:

1. knowing where you are — the date and place
2. attention and concentration
3. short-term memory (recall)
4. language skills
5. visual and spatial relationships between objects
6. ability to understand and follow instructions

What happens in the MMSE?

The MMSE is a test. You will be asked to do a set of tasks such as:

• Trying to remember a few objects and then repeating the list back later.
• Copying a drawing.
• Writing a short sentence with correct grammar. An example could be: "the dog sat on the floor".
• Correctly saying the current day of the week. You may also be asked to say the date, month, season and year.
• Correctly saying where you are.

The test takes about 5 to 10 minutes. The test is usually the same or similar for everyone.

It does not matter who gives you the test. It's the same whether it is done in hospital or by your doctor.

How is the MMSE scored?

The top score for the MMSE is 30. A score of 25 or higher is said to be normal. A score of below 24 could mean cognitive impairment.

What are the limitations of the MMSE?

There are limitations to the MMSE. By itself, the MMSE test does not mean that you have a problem with your mental ability. Your doctor or healthcare professional will look at all your other health results.

A low score does not always mean that you have dementia. Low scores can also be caused by:

• physical problems
• intellectual disability
• language or speech problems
• education level
• cultural differences

This is why other tests are needed.

A high MMSE score does not always mean that you have a normal mental ability. You may still have signs of cognitive impairment. For example, a very educated person with dementia can still score highly. This is possible early in dementia.

Your doctor will take all this into account when looking at your results. They will tell you if they think you should have further tests. An MMSE is just one way you can be tested for your mental ability.

Why might I be asked to repeat the test?

The MMSE may be repeated. This might be needed to check for changes in your mental ability over time. If your MMSE score goes down, your doctor might ask more questions about your health. They might need to arrange other tests.

The MMSE can be repeated for someone who has already been diagnosed with dementia. In this case, a repeat MMSE test may show how quickly their dementia is advancing.

If you are feeling anxious about the MMSE

The MMSE is a short set of questions. It is not trying to trick you. It asks you to do things that are part of normal daily life. It's 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
• by itself, the test will not diagnose you with any health issue — other tests are needed

Resources and support

Visit the Dementia Australia website to find out more or call the National Dementia Helpline on 1800 100 500 for information and support.

You can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.