1. Mini-Mental State Examination ここ () Orientation What is the (year) (season) (date) (day) (month)? Registration Name 3 objects: 1 second to say each. Then ask the patient all 3 after you have said them. Give 1 point for each correct answer. Then repeat them until he learns all 3. Count trials and record. Trials: Attention and Calculation Serial 7's. 1 point for each correct. Stop after 5 answers. Recall Ask for the 3 objects repeated above. Give 1 point for each correct. Language Name a pencil and watch (2 points). Repeat the following "No ifs, ands or buts" (1 point). "Take a paper in your right hand, fold it in half, Read and obey the following: Close your eyes (1 point). Write a sentence (1 point). Copy design (1 point). Total Score Assess level of consciousness along a continuum Alert Drowsy Stupor Coma Instructions for Administration of Mini-Mental State Examination Orientation (1) Ask for the date. Then ask specifically for parts omitted, e.g., "Can you also tell me what season it is?" One point for each correct. (2) Ask in turn "Can you tell me the name of this hospital?" (town, county, etc.). One point for each correct. Registration Ask the patient if you may test his memory. Then say the names of 3 unrelated objects, clearly and slowly, about one second for each. After you have said all 3, ask him to repeat them. This first repetition determines his score (0-3) but keep saying them until he can repeat all 3, up to 6 trials. If he does not eventually learn all 3, recall cannot be meaningfully tested. Attention and Calculation Ask the patient to begin with 100 and count backwards by 7. Stop after 5 subtractions (93, 86, 79, 72, 65). Score the total number of correct answers. If the patient cannot or will not perform this task, ask him to spell the word "world" backwards. The score is the number of letters in correct order, e.g., dlrow 5, dlorw= 3. = Recall Ask the patient if he can recall the 3 words you previously asked him to remember. Score 0-3. Language Naming: Show the patient a wrist watch and ask him what it is. Repeat for pencil. Score 0-2. Repetition: Ask the patient to repeat the sentence after you. Allow only one trial. Score 0 or 1. 3-Stage command: Give the patient a piece of plain blank paper and repeat the command. Score 1 point for each part correctly executed. Reading: On a blank piece of paper print the sentence "Close your eyes”, in letters large enough for the patient to see clearly. Ask him to read it and do what it says. Score 1 point only if he actually closes his eyes. Writing: Give the patient a blank piece of paper and ask him to write a sentence. Do not dictate a sentence, it is to be written spontaneously. It must contain a subject and verb and be sensible. Correct grammar and punctuation are not necessary. Copying: On a clean piece of paper, draw intersecting pentagons, each side about 1 in., and ask him to copy it exactly as it is. All 10 angles must be present and 2 must intersect to score 1 point. Tremor and rotation are ingored. Estimate the patient's level of sensorium along a continuum, from alert on the left to coma on the right. Reprinted from the Journal of Psychiatric Research, volume 12, Folstein MF, Folstein SE, McHugh PR. Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician. 196-8, 1975, with kind permission from Elsevier Science, Ltd., The Boulevard, Langford Lane, Kidlington OX5 1GB UK. Source: Adapted from Crum RM, Anthony JC, Bassett SS, et al. 2. The Blessed Orientation-Memory-Concentration (BOMC) Test Overview The six-item Blessed Orientation-Memory-Concentration (BOMC) test was developed by Katzman, Brown, Fuld, et al. (1983) from the longer (29-item) Blessed Information-Memory-Concentration (BIMC) test (Blessed, Tomlinson, and Roth, 1968). Katzman and colleagues (1983) selected 6 of the original 29 BIMC items based on a series of statistical analyses. The scores from each of the six items are multiplied as detailed below to yield a weighted score. Possible total scores on the BOMC range from 0 (all items answered correctly) to 28 (all items answered incorrectly). Weighted error scores greater than 10 are consistent with dementia, according to Katzman and colleagues. Score of 1 for each incorrect response; maximum weighted score = 28 Source: Katzman R, Brown T, Fuld P, et al. Validation of a short orientation-memory-concentration test of cognitive impairment. Am J Psychiatry 1983;140:734-9. Copyright 1983, American Psychiatric Association. Used with permission. |