Mini Mental Status Examination (MMSE) & Montreal Cognitive Assessment (MOCA)

Mini Mental Status Examination (MMSE) & Montreal Cognitive Assessment (MOCA)

Mini Mental Status Exam (MMSE)
Patient Name: John Moss
Examiner: (Your Name)
Date: September 20, 2024
Orientation: (Maximum Score: 5)
Questions:
What is the year? (2024)
What is the season? (Fall)
What is the date? (September 20th)
What is the day? (Friday)
What is the month? (September)
Where are we? (New York)
What country are we in? (United States)
What city are we in? (New York City)
What hospital are we in? (New York General Hospital)
What floor are we on? (2nd Floor)
Patient’s Score: 3/5
Observation: Date: John Moss said first “October 20th” then “Thursday,” after some hesitation, and corrected it. He was struggling with the floor of the hospital where he was staying, uttering “3rd Floor” then correcting himself to “2nd Floor.”

Registration: (Maximum Score: 3)
Task: The patient has been asked to identify three objects. These are an apple, a book, and a car.
Trials: 1
Patient’s Score: 3/3
Observation: John Moss repeated all three objects immediately.
Attention and Calculation (Maximum Score: 5)
Activity: Take away 7 from 100 (Serial 7’s). John Moss continued as follows:-
100 – 7 = 93
93 – 7 = 86
86 – 7 = 79
79 – 7 = 73 (correct 72)
Stopped after 4th subtraction mistake.
Patient’s Score: 4/5
Note: John Moss committed mistake on last subtraction.
Recall (Maximum Score: 3)
Activity: Recall the names of three objects that were mentioned to him in the registration part.
John remembered: apple, car, book (in correct sequence).
Patient’s Score: 3/3
Observation: He remembered all the objects in order.
Language
Naming (Maximum Score: 2)
Task: Name a pencil and a watch.
Patient’s Score: 2/2
Repetition (Maximum Score: 1)
Task: Repeat the sentence: “No ifs, ands, or buts.”
John made a pause and repeated, “No ifs, ands, or, um, but”
Patient’s Score: 0/1
Observation: He mispronounced the sentence and did so slightly with hesitation.
3-Stage Command (Maximum Score: 3)
Task: “Take a paper in your hand, fold it in half, and put it on the floor.”
John folded the paper in half but did not put it on the floor.
Patient’s Score: 2/3
Observation: He had followed two steps and did not put the paper on the floor.
Reading (Maximum Score: 1)
Task: Read and follow the command “CLOSE YOUR EYES.”
Patient’s Score: 1/1
Observation: He appropriately followed the command.
Writing (Maximum Score: 1)
Task: Write a sentence.
John, “I wish I was there.”
Patient’s Score: 0/1
Observation: The sentence was grammatically incorrect.
Copying (Maximum Score: 1)
Copy the two pentagons as shown in the examination.
Patient’s Score: 1/1
Observation: John has copied the pentagons correctly.
Total Score: 24/30

Level of Consciousness Assessment

John Moss appeared to be alert throughout the exam, though he showed signs of mild cognitive impairment. He was somewhat troubled with orientation, repetition, and complex commands. Attention and calculations were relatively intact, with minor errors. The MMSE score of 24/30 may also suggest mild cognitive impairment.

Montreal Cognitive Assessment (MOCA)

Name: John Moss
Education Level: College
Sex: Male
Date of Birth: January 1, 1950
Date: September 20, 2024

Visuospatial/Executive (Maximum Score: 5)
Task 1: Identifying circled letters and words in a pattern.
Appropriate circled letters and words: 1 point
Task 2: Copying a cube.
Accurate reproduction of the cube: 1 point
Task 3: Drawing a clock showing ten past eleven. (Total: 3 points)
Contour (Shape of the clock): 1 point
Numbers (Correctly placed numbers): 1 point
Hands (Incorrect positioning of the clock hands): 0/1 point
Patient’s Score: 4/5
Observation: John has drawn the clock correctly. He has placed the hands at twelve past eleven instead of ten past.
Naming (Points :3)
Task 1: Naming an elephant.
Task 2: Naming a rhinoceros.
Task 3: Naming a camel.
Patient’s score: 3/3
Observation: He correctly identified all three animals.
Memory (No points. This is just for assessment):
Task: Read to the patient the following list of words and ask them to repeat them. Conduct two trials. Recalling, do after 15 minutes.
Words: Face, Velvet, Church, Daisy, Red
1st trial and 2nd trial repetitions observed.
Attention (Maximum Score: 6)
Task 1: Repeat numbers in the forward order. (Sequence: 2 1 8 5 4)
Patient’s Score: 1 point
Task 2: Repeat numbers in the backward order. (Sequence: 7 4 2)
Patient’s Score: 1 point
Task 3: Tap with hand every time the letter “A” is spoken. Sequence: FBACMNAAJKLBAFAKDEAAAJAMOFAAB
Patient’s Score: 1 point (0 points if ≥ 2 errors)
Task 4: Serial 7 subtraction starting from 100.
100 – 7 = 93
93 – 7 = 86
86 – 7 = 79
79 – 7 = 72
72 – 7 = 65
Patient’s Score: 2/3
Observation: John did one error and stopped at 79.
Language (Maximum Score: 3)
Task 1: Repeat the following sentences:
“I only know that John is the one to help today.”
“The cat always hid under the couch when dogs were in the room.”
Patient’s Score: 2/2
Task 2: Fluency: Name as many words as possible in one minute that begin with the letter F.
(N ≥ 11 words = 1 point)
Patient’s Score: 1/1
Observation: John named 12 words.
Abstraction (Maximum Score: 2)
Task: Find the similarity between:
Banana and orange = Fruit
Train and bicycle = Transportation
Watch and ruler = Measuring devices
Patient’s Score: 2/2
Observation: He answered both correctly.
Delayed Recall (Maximum Score: 5)
Instructions: Ask the subject to recall the words given earlier in the exercise (Face, Velvet, Church, Daisy, Red).
Patient’s Score: 3/5
Observation: John could recall only “Face,” “Velvet,” and “Church” without any cues and needed cues for remembering “Daisy” and “Red.”
Orientation (Maximum Score: 6)
Instructions: Request the patient to provide the following information:
Date: September 20th
Month: September
Year: 2024
Day: Friday
Place: New York General Hospital
City: New York City
Patient’s Mark: 6/6
Observation: John was able to answer all of the questions correctly.
Total: 26/30

Reference

Arevalo-Rodriguez, I., Smailagic, N., Roqué-Figuls, M., Ciapponi, A., Sanchez-Perez, E., Giannakou, A., … & Cullum, S. (2021). Mini‐Mental State Examination (MMSE) for the early detection of dementia in people with mild cognitive impairment (MCI). Cochrane Database of Systematic Reviews, (7). https://doi.org/10.1002/14651858.CD010783.pub3

Jia, X., Wang, Z., Huang, F., Su, C., Du, W., Jiang, H., … & Zhang, B. (2021). A comparison of the Mini-Mental State Examination (MMSE) with the Montreal Cognitive Assessment (MoCA) for mild cognitive impairment screening in Chinese middle-aged and older population: a cross-sectional study. BMC psychiatry, 21, 1-13.

Myrberg, K., Hydén, L. C., & Samuelsson, C. (2020). The mini-mental state examination (MMSE) from a language perspective: an analysis of test interaction. Clinical linguistics & phonetics, 34(7), 652-670. https://doi.org/10.1080/02699206.2019.1687757

Mini Mental Status Examination (MMSE) & Montreal Cognitive Assessment (MOCA)

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