Mental status examination

Troels Kjaer MD PhD (

Dr. Kjaer of Zealand University Hospital received consulting fees from UNEEG Medical.

Karin Norgaard PhD (

Dr. Norgaard of Rigshospitalet University Hospital, Glostrup, 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 October 16, 2020; expires October 16, 2023


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 Mini-Mental Status Examination (MMSE) is the most widely used instrument to rapidly assess the cognitive status of individuals, both in clinical and research settings.


• The Montreal Cognitive Assessment (MoCA) is a newer tool that seems to be more sensitive in mild cognitive impairment.


• The Hong Kong Brief Cognitive Test (HKBC) is useful in population with low educational level.


• The Addenbrooke's Cognitive Assessment III (ACE-III) identifies everyday functional impairments.

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), Modified Mini-Mental State Examination (3MS) (Teng and Chui 1987), Montreal Cognitive Assessment (MoCA) (Nasreddine et al 2005), and Addenbrooke's Cognitive Assessment III (ACE-III) (Hsieh et al 2013).

The best known of these tools is the MMSE.

Mini-Mental State Examination 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. The MoCA scale seems to be more sensitive in the early stages of Alzheimer disease and mild cognitive impairment.

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