How is the Folstein Mini-Mental State Exam performed in the evaluation of vascular dementia?

Updated: Mar 26, 2018
  • Author: Kannayiram Alagiakrishnan, MD, MBBS, MPH, MHA; Chief Editor: Glen L Xiong, MD  more...
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Answer

A commonly used cognitive screening tool is the Folstein Mini-Mental State Examination. Patchy defects are present in persons with vascular dementia. The deficits are global in persons with Alzheimer dementia.

The Folstein Mini-Mental State Examination is as follows:

  • Orientation: First, ask the patient the date, day, month, year, and season. The maximum score is 5. Second, ask the patient their current location, i.e., facility, floor, town, state, and country. The maximum score is 5.

  • Registration: Name 3 objects (e.g., ball, flag, door), and ask the patient to repeat them. The maximum score is 3.

  • Attention: Ask the patient to spell the word "world" backwards or to subtract 7 from 100 serially backwards (stop after 5 answers). The maximum score is 5.

  • Recall: Ask the patient to remember the 3 objects from the Registration portion of the test. The maximum score is 3.

  • Language

  • Ask the patient to identify a pencil and a watch. The maximum score is 2. Ask the patient to repeat the phrase "no ifs, ands, or buts." The maximum score is 1. Ask the patient to follow a 3-step command. The maximum score is 3. Ask the patient to read and obey the phrase "close your eyes." The maximum score is 1. Ask the patient to write a sentence. The maximum score is 1. Ask the patient to copy a set of interlocking pentagons. The maximum score is 1.

  • Scoring: The maximum score possible is 30. Generally, any score less than 24 is considered abnormal, but the cutoff varies with the patient's level of education. Because the results for this test can vary over time, and for some people results can vary during the day, record when (i.e., the time and date) this test was performed. [17]


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