Appendix C: Folstein Mini-Mental State Examination

Folstein Mini-Mental State Examination

The Folstein Mini-Mental State Examination is the preferred tool for assessing the mental status of a patient with suspected cognitive impairment. To perform the examination, ask the patient to follow a series of simple commands that test his ability to understand and perform cognitive functions. Award a designated point value for successful completion of each instruction, then total the scores to determine the patient's mental status. Scores of 26 to 30 indicate that the patient is normal; 22 to 25, mildly impaired; and less than 22, significantly impaired.

PATIENT INSTRUCTIONS MAXIMUM SCORES ACTUAL SCORE

Orientation

Ask the patient to name the year, sea son, date, day, and month. (Score one point for each correct response.)

5 ( )

Ask the patient to name his state, city, street, and house address, and the room in which he is standing. (Score one point for each correct response.)

5 ( )

Comprehension
Name three objects, pausing 1 second between each name. Then ask the patient to repeat all three names. (Score one point for each correct response.) Repeat this exercise until the patient can correctly name all three objects (the patient will be tested on his ability to recall this information later in the examination). 3 ( )

Attention and calculation
Ask the patient to count backward by sevens, beginning at 100; have him stop after counting out five numbers. Alternatively, ask the patient to spell "World" backward. (Score one point for each correct response.) 5 ( )

Recall
Ask the patient to restate the name of the three objects previously identified in the examination. (Score one point for each correct response.) 3 ( )

Language

Point to a pencil and a watch. Ask the patient to identify each object. (Score one point for each correct response.)

2 ( )

Ask the patient to repeat "No ifs, ands, or buts." (Score one point for a correct response.)

1 ( )

Ask the patient to take a paper in his right hand, then fold the paper in half, then put the paper on the floor. (Score one point for each correct response to this three-part command.)

3 ( )

Ask the patient to read and obey the written instruction "Close your eyes." (Score one point for a correct response.)

1 ( )

Ask the patient to write a sentence. (Score one point for a correct response.)

1 ( )

Ask the patient to copy the following design. (Score one point for a correct response.)

1 ( )

Adapted with permission from Folstein, M.F, et al. "Mini-Mental State: A Practical Method for Grading the Cognitive State of Patients for the Clinician," Journal of Psychiatric Research 12: 196-97, 1975

Folstein Mini-Mental State Examination
The Folstein Mini-Mental State Examination is the preferred tool for assessing the mental status of a patient with suspected cognitive impairment. To perform the examination, ask the patient to follow a series of simple commands that test his ability to understand and perform cognitive functions. Award a designated point value for successful completion of each instruction, then total the scores to determine the patient's mental status. Scores of 26 to 30 indicate that the patient is normal; 22 to 25, mildly impaired; and less than 22, significantly impaired.
PATIENT INSTRUCTIONS	MAXIMUM SCORES	ACTUAL SCORE
Orientation Ask the patient to name the year, sea son, date, day, and month. (Score one point for each correct response.)	5	( )
Ask the patient to name his state, city, street, and house address, and the room in which he is standing. (Score one point for each correct response.)	5	( )
Comprehension Name three objects, pausing 1 second between each name. Then ask the patient to repeat all three names. (Score one point for each correct response.) Repeat this exercise until the patient can correctly name all three objects (the patient will be tested on his ability to recall this information later in the examination).	3	( )
Attention and calculation Ask the patient to count backward by sevens, beginning at 100; have him stop after counting out five numbers. Alternatively, ask the patient to spell "World" backward. (Score one point for each correct response.)	5	( )
Recall Ask the patient to restate the name of the three objects previously identified in the examination. (Score one point for each correct response.)	3	( )
Language Point to a pencil and a watch. Ask the patient to identify each object. (Score one point for each correct response.)	2	( )
Ask the patient to repeat "No ifs, ands, or buts." (Score one point for a correct response.)	1	( )
Ask the patient to take a paper in his right hand, then fold the paper in half, then put the paper on the floor. (Score one point for each correct response to this three-part command.)	3	( )
Ask the patient to read and obey the written instruction "Close your eyes." (Score one point for a correct response.)	1	( )
Ask the patient to write a sentence. (Score one point for a correct response.)	1	( )
Ask the patient to copy the following design. (Score one point for a correct response.)	1	( )
Adapted with permission from Folstein, M.F, et al. "Mini-Mental State: A Practical Method for Grading the Cognitive State of Patients for the Clinician," Journal of Psychiatric Research 12: 196-97, 1975