Mental status examination

Troels Kjaer MD PhD (Dr. Kjaer of Roskilde University Hospital has no relevant financial relationships to disclose.)
Karin Norgaard PhD (Dr. Norgaard of Glostrup University Hospital has no relevant financial relationships to disclose.)
Victor W Mark MD, editor. (Dr. Mark of the University of Alabama at Birmingham has no relevant financial relationships to disclose.)
Originally released May 12, 1999; last updated July 27, 2015; expires July 27, 2018

Overview

The authors have reviewed the literature on mental status examination and discuss testing of various composite cognitive domains.

Key points

 

• Bedside mental status examination tools have been developed to combine ease of administration with standardized scoring.

 

• The MMSE is the most widely used instrument to rapidly assess the cognitive status of individuals, both in clinical and research settings.

 

• The MMSE is good for screening and for evaluation of treatment effect.

Historical note and terminology

Mental status examinations span a wide range of sophistication, from observation of the patient during history-taking and physical examination to extensive neuropsychological testing in standardized settings. Bedside mental status examination tools have been developed to combine ease of administration with standardized scoring. One of the first test batteries was created by Klein and Mayer-Gross (Klein and Mayer-Gross 1957). Other test batteries include: Kahn's Mental Status Questionnaire (Kahn et al 1960), Short Portable Mental Status Questionnaire (Pfeiffer 1975), Mattis Dementia Rating Scale (Mattis 1976), Cognitive Capacity Screening Examination (Jacobs et al 1977), Mini-Mental Status Examination (MMSE) (Folstein et al 1975), and Modified Mini-Mental State Examination (3MS) (Teng and Chui 1987).

The best known of these tools is the MMSE.

Image: Mini-Mental State Examination
The MMSE was primarily developed to screen for organic behavioral signs and facilitate the diagnosis of general organic mental syndromes (eg, dementia) or specific organic mental disorders (eg, Alzheimer disease). As efficient treatment of these conditions has become available, the MMSE has been used to evaluate treatment effect.

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