The most widely used evaluation test for Dementia is the Mini-Mental State Examination (MMSE).

The test can be broken down into the following sections:

Orientation (10 points), Registration (3 points), Attention/Calculation (5 points), Recall (3 points), Language and Praxis (9 points).

Time Orientation: Year, season, date, day, month

(score 1 point for each correct answer)

Place Orientation: country, state, city, building, floor

(score 1 point for each)

Registration: The examiner names 3 words and the patient repeats them immediately.

(1 point for each correct answer)

Attention/Calculation: Serial 7's. Examiner Asks what is 100-7 (93), 93-7 (86), 86-7 (79), 79-7 (72), 72-7 (65). Or can ask to spell the word World backwards (with 1 point for each correctly placed letter).

(1 point for each correct answer)

Recall: After 5 minutes, the examiner invites the patient to repeat the 3 words he asked the patient to remember previously. I always used the same 3 words: Mouse, Pencil, and Ball.

(one point for each correct answer)

Language and Praxis:

Naming-identify two objects (watch and pen, for example). (1 point for each correct answer)

Repetition: repeat the phrase "No ifs, ands, or buts." (1 point)

Three Step Command: Take this paper, fold it in half, and set it down (1 point for each phase)

Read and Obey the following phrase (after writing it down for the patient): "Close your eyes."

(1 point)

Copying Design: Draw two intersecting pentagons.

(1 point)

Scores below 24 are highly associated with cognitive loss. 18-33 mild cognitive impairment, 0-17 severe cognitive impairment.

Editor's note: This is the MMSE strictly speaking. I liked to use most of the questions, eliminate others, add several more, and ball-park the scoring. In doing so, I wasn't too interested in an exact score but more of a general idea if the patient had dementia or not. Getting a general idea if a patient has dementia I found more practical than jotting a definitive score, plus scores can vary as patients with dementia often have better or worse days. I found the 3 word recall at 5 minutes the most valuable. I often added the clock drawing test where the patient is asked to draw a clock face and put in all the numbers of the clock and set the hands to indicate a specific time, say 3:10. This can also be kept in the patient's chart and added to yearly to assess for decline.