FOLSTEIN MMSE PDF
Folstein Mini-Mental State Exam. I. ORIENTATION (Ask the following questions; correct = ☑). Record Each Answer: (Maximum Score = 10). What is today's date. Folstein MF, Folstein SE, McHugh PR: “Mini-mental state: A practical method for .. Differentiate Aging and Dementia exactly as it appears in the PDF available. that an MMSE score is Note: The MMSE is a required part of this dementia assessment. Crum, R. M., J. C. Anthony, S. S. Bassett, and M. F. Folstein.
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Give a 3 stage command. Score 1 for each stage. Eg. "Place index finger of right hand on your nose and then on your left ear". Ask patient to read and obey a. A common measurement scale used in older adults is the Folstein Mini Mental State Exam (MMSE). The MMSE was designed to screen for. TOTAL. (Adapted from Rovner & Folstein, ). Source: resourceone.infone. resourceone.info Provided by NHCQF,
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The MMSE is not an adequate screening cognitive instrument in studies of late-life depression.
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Mini–Mental State Examination
Chopra et al. Normal Borderline impairment Mild impairment Moderate impairment Severe impairment. Ferrell et al. Kaasalainen et al. Scherder and Bouma Krulewitch et al. Tsai et al. Radbruch et al. Shega et al. Ryu and Kwon Jervis et al. Education mean Dong et al.
Shigemori et al. Neurological exam that included assessment of hearing and visual capacity. Morgado et al. Wiig et al. Wouters et al.
Kovacevic et al. Guerrero-Berroa et al. Nazem et al. Average education level Nelson et al. Brugnolo et al. Carcaillon et al. Low to very low scores correlate closely with the presence of dementia , although other mental disorders can also lead to abnormal findings on MMSE testing. The presence of purely physical problems can also interfere with interpretation if not properly noted; for example, a patient may be physically unable to hear or read instructions properly or may have a motor deficit that affects writing and drawing skills.
The MMSE has been able to differentiate different types of dementias. Studies have found that patients with Alzheimer's disease score significantly lower on orientation to time and place, and recall compared to patients with dementia with Lewy bodies, vascular dementia and Parkinson's disease dementia.
It should not serve as the sole criterion for diagnosing dementia or to differentiate between various forms of dementia. The MMSE should not be used clinically unless the person has at least a grade eight education and is fluent in English.
While this recommendation does not discount the possibility that future research may show that number of years of education constitutes a risk factor for dementia, it does acknowledge the weight of evidence showing that low educational levels substantially increase the likelihood of misclassifying normal subjects as cognitively impaired Serial 7's and WORLD should not be considered equivalent items.
A reliability test-retest was carried out and will be published timely. Therefore, the "reference test" for diagnosis of dementia syndrome was the specialists' opinion RA2 based on their structured clinical evaluations and patient's performance in the neuropsychological test according to DSM-IV2 and International Classification of Diseases ICD criteria.
MMSE results were kept in a sealed envelope to prevent the knowledge of subject's performance to affect RA2's diagnostic decision.
Mini-Mental State Examination for the Detection of Dementia in Older Patients
Data were entered in the Epi Info software program, version 6. Comparisons of frequency between categorical variables were performed using Chi-square test and mean comparison between two groups were carried out through variance analysis. For comparing means of variables with a non-normal distribution a non-parametric Kruskal-Wallis test was used. SPSS statistical package, version 9.
Positive predictive value PVpos and negative predictive value PVneg were estimated based on contingency tables. Only 4. Schooling in dementia and non-dementia subjects had a median of 1 and 4, and a mean of 1. Table 2 shows the statistical values of other variables in these two groups. Table 3 shows the frequencies of reported preexisting diseases.
The estimated ROC curve had an area under the curve of 0. Because of that, the sample was divided in two subgroups: illiterate and educated. Its structure and psychometric characteristics have been extensively reviewed and many translations and cultural adaptations have been produced as well. In Brazil, investigators1,4 have suggested literally translating most MMSE items, such as those assessing time orientation except for "season of the year" , attention and calculation, object naming, understanding of spoken and written commands as well as those assessing writing and visual-spatial abilities.
But these authors had also suggested that other items be adapted as they were not appropriate to cultural characteristics of Brazilian population.
Nevertheless, some of these suggestions are still being discussed: How assessment of time and space orientation can be improved? What are the most adequate words for registration and recall?
What is the best sentence to be repeated? In the present study the translated tool by Bertolucci et al4 and approved by Almeida1 was found to be largely appropriate but some modifications were needed.
On one hand, it was more consistent with Folstein et al's9 original propositions; for instance, the choice of widely used simple two-syllable words for learning and recall. On the other hand, a few inadequate choices were changed such as the use of "semester" instead for time orientation. This division of the year is basically part of the collective school learning and so it is not familiar to most individuals seen at public health services, as those selected to participate in this study.
The fact no study has so far addressed the important issue of using adequate methodology for transculturally adapting this instrument perpetuates a number of issues concerning informal adaptations. Also, as the present study did not include these issues in its objectives, they are still untackled. To assess cognitive performance of those seeking care in a hospital's medical triage service, Bertolucci et al4 administered the MMSE to patients.
There were found distinct cutoff points for diagnosis of cognitive impairment according to schooling: 13 for illiterate, 18 for low to intermediate schooling and 26 for high schooling, with These cutoff points have been widely accepted by some authors and services. However, methodology issues related to the study design showed their main findings needed to be reviewed.
These issues were summarized by Almeida1 as follows: a it was not possible to establish whether some individuals out of assessed in the screening had dementia; b 70 out of 94 controls for cognitive impairment were diagnosed with delirium but not dementia; c most interviewees aged less than 60 years; d study controls were not psychically assessed.
Similarly, aiming at exploring the best cutoff point in MMSE for the elderly and the impact of age and schooling on this population's scores, Almeida1 studied subjects aged 60 years or more seen in a mental health outpatient clinic. After comparing scores of dementia and non-dementia patients, Almeida1 concluded that distinct cutoff points according to patient's past school experience were required. Almeida1 also concluded that " They assessed subjects, of which were escorts of patients attending a neurology outpatient clinic in a general hospital and were randomly selected from a sample of an epidemiological study carried out in the city of Catanduva, Southeastern Brazil; subjects had 65 or more years.
Once more it was found schooling was a major factor affecting performance. As it was said before, psychometric characteristics of the MMSE in Brazil have been assessed thus far in mental health outpatients or patients from various health care services.This division of the year is basically part of the collective school learning and so it is not familiar to most individuals seen at public health services, as those selected to participate in this study.
Differences exist between people with moderate, moderately severe, severe, and very severe cognitive impairment Paquay et al. Specifically, we reviewed the methods sections of research studies using the MMSE on reporting education, sensory status, and fluency in language. Acknowledgments The authors gratefully acknowledge Gail Spake for her editorial refinement of this article. Assessment of older people: self-maintaining and instrumental activities of daily living.
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