When we are evaluating "dementia" patients the challenges become - the MMSE seems to evaluate motor and sensory while working through the testing - yet so many other aspects of the patient are unable to be measured, judged, graded, or scored... ( compassion, empathy, spirituality, insight, curiosity, and so on.) - Just can't score a patients creativity! As for the question - the MMSE score change is what I see most healthcare teams using and generally literature 12=severe 21=moderate "dementia".

Hi there,

Would you be using the English version (Folstein)?

I used the Italian version which had an interesting score balancer using age and years of education to adjust the score.

To be honest, I think the MMSE has some limitations and cannot be used alone without further neuropsychological assessment. For example, some of the participants in my study had been retired for a long time and had problems remembering the date or which day of the week it was simply because they did not need to know. To further break down the problem with this, a participant answered 1956 to the question "what year is it", while another answered 2017. Since the score is either 0 or 1, these two people's answers weighted the same while it is clear that they cannot be compared.

Cut-off scores seem to be different between different versions of the MMSE.

Hi Elene,

Our hospital has moved away from the MMSE as it has been copyrighted and you need to pay per use. We are using the ACE-iii (Addenbrooke's Cognitive Examination) and the MOCA (Montreal Cognitive Assessment)

We did a small study to validate these in our settings

Article Performance of three cognitive screening tools in a sample o...

Thank you very much for this interesting answers. I am planing a study in elderly (65+) and would like to exclude them if they have dementia or other cognitive problems. The tool for assessment should be easy and short, validated (+free of charge) to administer for clinicians. Thats why I decided to use MMSE Short Form with 6-7 items. Does anyone know what would be the cut-off score for it?

Hi Elene,

The publishers of the MMSE asserted their copyright for any of the content of the MMSE, including anything that uses questions from the MMSE:

" two groups of researchers who developed new tests that reportedly improved on the MMSE -- the Sweet-16, and the ACE-R -- have been asked to remove those tests from their websites by the company that manages copyright for the MMSE, Psychological Assessment Resources (PAR)... physicians are technically required to purchase an MMSE form that costs $1.23 for each patient evaluated ".(Fiore, 2015)

So with that caveat...there are a number of short forms of the MMSE and you will need to use the cut-off that performed best in the psychometric testing for the version that you are using. You may want to emphasise sensitivity to 'be on the safe side'.

In any case 6-7 item seems to me too short for a satisfactory assessment, even a brief one . In my clinical practice I use often the same questions of MMSE without an official scoring, then I decide to send the patient for MOCA to neuropsychologist.