It is easy to establish an achievement score and thereby get an idea of a person’s level of cognitive functioning. Unfortunately it is a coarse test and mild cognitive impairment will have to be ascertained using other tests.

When the MMSE is administered, it is important that Folstein’s instructions are followed in order that mutual comparisons are possible.

Using the MMSE
Inform the person that you are going to ask a few questions and request that the best possible answers be given. Also explain to the person that some questions will be easier while others are more difficult. Apologise for the (ridiculously) easy questions, but request that you would still appreciate it were they to give you an answer.

See the table below for guidelines on its application. The eleven sub-divisions measure different cognitive functions and a specific sub-division can measure more than one cognitive function.

Meaning of results
A score of 24 or less out of 30 indicates global cognitive impairment. This impairment can result from delirium or dementia. Should it have started recently and show a fluctuating course then delirium is more likely. Dementia, on the other hand, is characterised by a gradual and progressive deterioration in cognitive abilities over months and years.

MMSE scores are determined by level of education and age. The average score for adults up to the age of 50 years is 29. After this it decreases to an average score of 25 in persons over the age of 80 years. The average score for persons with a high school education and more is 29. For persons with one to five years of schooling the average score is 22. In South Africa a score of 29 or more can be expected in people with a standard 5 (grade 7) or higher education. Therefore keep education and age in mind when interpreting results.

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