Mmse Essay

Topics: Psychiatry, Mini-mental state examination, Alzheimer's disease Pages: 12 (4514 words) Published: March 18, 2011
Task one:
Folsteins Mini Mental State Examination (MMSE) was first described by Marshall F. Folstein, Suzan Folstein, & Paul R. McHugh (as cited in International Journal of Geriatric Psychiatry, 2009). Marshall Folstein, a neuropsychiatrist, created the MMSE overnight because he was not happy with a patients’ cognitive report written by wife Suzan Folstein, a psychiatrist. He presented the MMSE to the clinical director Paul R. McHugh who acknowledged the significance of MMSE to clinicians and epidemiologists in many countries (Folstein, 1990). MMSE was originally designed to provide a brief, standardized assessment of mental status in psychiatric patients, and now detects and tracks the development of cognitive impairment in conditions such as Alzheimer’s disease (Bowden & Meade, 2005). The aim of MMSE is to screen for cognitive impairment, assess the severity of any impairment, and monitor change by serial testing (Ridha & Rossor, 2010). It does not focus on a client’s mood, thought content, judgment and insight like the mental status examination does, but focuses on the cognitive aspects of a client’s mental purposes (Towsend, 2008). That is why it is called “mini” because it refers to the fact that this tool only concentrates on cognitive features of mental functioning of the client (Jensen & Hansen, 2008). According to Caritas Health Group (n.d.), MMSE is a well validated screening tool for cognitive impairment by briefly measuring orientation, short term verbal memory, immediate recall, calculation, language, and constructs ability. The clients will be asked the year, season, date, month and day of the week, name three objects, use their calculation ability by subtracting seven at least five times from 100 or spell the word world backward, test their recall ability by repeating the three objects mentioned and also test their language and constructing ability. They receive one point for each correct answer (Hickey, 2003).

The test consists of 11 items that are easily given and executed, each corresponding to a cognitive functional area with a total maximum possible score of 30/30 (Costarella, et al., 2010). Scores range from 25-30 for no cognitive impairment, 21-24 for mild dementia, 14-20 for moderate, and less than 13 in severe dementia clients (Rockwood, n.d.). Many clinicians ask additional questions to the client like “What would you do if you were in a crowded building and smelled smoke?” for further assessment, as judgment and insight are not tested by this tool (Santacruz & Swagerty, 2001).

The test is easy except the calculation which is more complex that requires extra time for the individual to think more (Bhakti, et al., 2001). There are some factors that influence the MMSE score that the examiner should consider like; depression, delirium and educational level (Jensen, 2005). In addition, MMSE is also based on the person’s age, gender and IQ and evaluates the predicted score that the client actually achieved (Green, Keaff, Knight & McMahon, 2006). In regard to education, the number of years in school is not the only basis of MMSE screening but also the quality of education that accounts for scoring differences (Peggy, 2002). For example, a farmer may have a lower MMSE score compared to white collar workers, even after adjustment for age, financial dissatisfaction and education (Peggy, 2002).

Task two:
What
MMSE is a very simple, easily administered mental status examination that has proved to be a more valid instrument and highly reliable for detecting cognitive impairment than using informal questioning and client’s overall impressions (MidAmerica Neuroscience Institute, 2006). It is a brief screening tool that includes items measuring a range of cognitive skills (Green, et al., 2006). It is the test that the National Health Services will recommend whether the drug treatment for Alzheimer’s disease will be prescribed to the client (Associated Newspapers Ltd., 2010)....

References: Aging Home Health Care. (2010). Dementia stages can be detected and gauged by Mini Mental State Exam. Retrieved May 8, 2010 from: http://www.aginghomehealthcare.com/dementia_stages.html.
Alzheimer’s Society. (2010). Leading the fight against dementia. Retrieved May 19, 2010 from: http://alzheimers.org.uk/site/index.php.
Alzheimer’s Association. (2009). New cases of Alzheimer 's and dementia continue to rise, even in the 'oldest old '. Retrieve May 20, 2010 from: http://www.sciencedaily.com/releases/2009/07/090713085006.htm.
Anthony, J. C., Bassett, S. S., Crum, R. M., & Folstein, M. F. (1993). The total MMSE score. Journal of the American Medical Association, 269(18), p. 2389.
Associated Newspapers Ltd
Averbuch, R. (2010). Mini Mental State Exam. Retrieved May 15, 2010 from: http://medinfo.ufl.edu:8050/year1/humbehav/3_31_09_mini_mental_state_exam_averbuch_hac_instructions.pdf.
Billig, N., Cohen-Mansfield, J., & Stockton, P. (1998). The validity of cognitive testing in screening for dementia. Retrieved may 10, 2010 from: http://www.springerlink.com/content/w2j2m58322141037/fulltext.pdf.
Bowden, C., & Meade, C. (2005). Diagnosing dementia: mental status testing and beyond. Retrieved May 15, 2010 from: http://www.australianprescriber.com/upload/pdf/articles/42.pdf.
Caritas Health Group. (n.d.). Instructions for administration of Mini-Mental State Examination. Retrieved May 4, 2010 from: http://www.palliative.org/PC/ClinicalInfo/AssessmentTools/instruct%20for%20admin%20mmse.pdf.
Cockrell R. J. & Folstein, M. F. (1988). Mini Mental State Examination (MMSE). Retrieved may 8, 2010 from: http://www.brain.northwestern.edu/pdfs/LEP/tools/mmse_article_cockrell_folstein.pdf.
Elder, R., Evan, K., & Nizette, D. (2009). Psychiatric and mental health nursing (2nd ed.). Sydney: Mosby Elsevier.
Fitcher, T., Meller, I., Schroppel, H. & Steinkirchner, R. (1995). Dementia and cognitive impairment in the oldest old in the community. Retrieved May 20, 2010 from http://bjp.rcpsych.org/cgi/content/abstract/166/5/621.
Folsten, M. (1990). This week’s citation classic. Retrieved May 18, 2010 from: http://www.garfield.library.upenn.edu/classics1990/A1990CE78800001.pdf.
Hickey, J. V. (2003). The clinical practice of neurological and neurological nursing (5th ed.). Philadelphia : Lippincott Williams & Wilkins.
Hospice of the Valley. (n.d.). Mini-Mental State Exam (MMSE) The gold standard in assessment of mental status. Retrieved May 11, 2010 from: http://www.hov.org/pdf/DDFeb07MMSEWebsite.pdf.
Jensen, A. (2005). How help uses the Mini-Mental State Exam. Retrieved May 10, 2010 from: http://www.mth.org/Help%20lines%20Newsletter%20december%202005.pdf.
Kennard, C. (2005). Is dementia age related? Retrieved May 21, 2010 from: http://alzheimers.about.com/od/research/a/age_dementia.htm.
Kurlowics, L. & Wallace, M. (1999). The Mini Mental State Examination (MMSE). Retrieved May 18, 2010 from: http://www.nzgg.org.nz/download/files/10.MMSEcopy.PDF.
MedicineNet.Inc. (2010). What conditions are not dementia? Retrieved May 20, 2010 from: http://ageing.oxfordjournals.org/cgi/content/full/37/5/593.
Melbourne Health. (n.d.). Tool and resource evaluation template. Retrieved May 17, 2010 from: http://www.health.vic.gov.au/older/toolkit/06Cognition/01Delirium/docs/Mini-Mental%20State%20Examination%20(MMSE).pdf.
Merrett , S., (2003). Mini -Mental State Examination. Retrieved May 13, 2010 from: http://www.progettoalzheimer.org/mmse.pdf.
Mid America Neuroscience Institute. (2006). Diagnosing dementia:
Is the Mini-Mental Status Examination reliable? Retrieved from May 17, 2010 from: http://www.neurokc.com/mani2.aspx?pgID=980.
Mohr, W. K. (2003). Psychiatric mental health nursing (5th ed.). Philadelphia: Lippincott Williams & Wilkins.
National Institute of Health. (2008). Detecting dementia with the Mini-Mental State Examination (MMSE) in highly educated individuals. Retrieved May 9, 2010 from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2587038/.
Nation Master.com. (n.d.). Mini Mental State Examination. Retrieved May 19, 2010 from: http://www.statemaster.com/encyclopedia/Mini_mental-state-examination.
Oxford Journals. (2008). A Mini Mental Status Examination for hearing impaired. Retrieved May 4, 2010 from: http://ageing.oxfordjournals.org/cgi/content/full/37/5/593.
PAR, Inc. (2010). Mini-Mental State Examination (MMSE). Retrieved May 12, 2010 from: http://www4.parinc.com/Products/Product.aspx?ProductID=MMSE.
Peggy, E. (2002). Why screening tests for dementia lead to over diagnosis for African Americans. Retrieved May 11, 2010 from:http://journals.lww.com/neurotodayonline/Fulltext/2002/01000/Why_Screening_Tests_for_Dementia_Lead_To_Over.12.aspx.
Ridha, B. & Rossor, M. (2010). The Mini Mental State Examination. Retrieved May 15, 2010 from: http://pn.bmj.com/content/5/5/298.abstract.
Rockwood, K. (n.d.). MMSE: Where does it fit? Retrieved from May 13, 2010 from: http://www.theberries.ca/Archives/SPRING2002/MMSE.html.
Rozenweig, A. (2010). Health care proxies for people with alzheimer’s diasease. Retrieved May 19, 2010 from: http://alzheimers.about.com/.
Santacruz, K., & Swagerty, D. (2001). Early diagnosis of dementia. Retrieve May 17, 2010 from: http://www.aafp.org/afp/2001/0215/p703.html.
Simard, M. (1998). The Mini Mental State Examination: Strength and weaknesses of the clinical instrument. Retrieved May 17, 2010 from: http://www.stacommunications.com/customcomm/Back-issue_pages/AD_Review/adPDFs/december1998/10.pdf.
Shives, L. R. (2008). Basic concepts of psychiatric-mental health nursing (7th ed.). Philadelphia : Wolters Kluwer / Lippincott Williams & Wilkins.
Stead, A. L. (2009). The Mini-Mental State Examination: What an SLP Needs to Know. Retrieved May 19, 2010 from: http://www.speechpathology.com/articles/article_detail.asp?article_id=379.
Suite 101.com. (2008). MMSE-popular mental status exam. Retrieved May 8, 2010 from: http://seniors-health-medicare .suite101 .com /article.cfm/mmsepopular_mental_status_exam.
The Dementia Caregivers Toolbox. (2010). Dementia cognitive testing- The “SLUMS” Test. Retrieved May 12, 2010 from: http://nurturingnuggets.typepad.com/the_nurturing_nuggets_blo/2010/03/dementia-cognitive-testing-the-slums-test.html.
The Hartford Institute for Geriatric Nursing. (n.d.). Screening tool: The Mini-Mental State Examination (MMSE). Retrieved May 17, 2010 from: http://nursinghomes.tmf.org/Portals/16/Documents/NH/Toolkits/Depression/MiniMentalStateExam.pdf.
Zhang, Z. (2005). Gender differentials in cognitive impairment of the oldest old in china. Retrieve May 20, 2010 from: http://paa2005.princeton.edu/abstractViewer.aspx?submissionId=50465.
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