Folstein Mini-Mental State Examination (MMSE): Mnemonic

ORARL, 5-3-5-3-9

1. Orientation:

  • Time (5 points – 1 for each correct): What is the: (year) (season) (date) (day) (month)?
  • Place (5 points – 1 for each correct): Where are we: (state) (county) (town) (hospital) (floor)?

2. Registration: Name three objects, ask patient to repeat (3 points – 1 for each on first repetition; allow upto 6 trials)

3. Attention/Calculation: Serial 7 substraction Or Spell “WORLD” backward (5 points – 1 point for each in correct order)

  • 93, 86, 79, 72, 65…….
  • D-L-R-O-W

4. Recall: Ask the patient to rename the three objects stated earlier (3 points – 1 point for each)

5. Language: 9 points

mmse

Language: 2, 3 DRaW

2 (2 points – 1 point for each) – Name 2 objects (pen and watch)

3 (3 points – 1 point for each) – Follow 3 step commands (“Take this paper from my hand, fold it in half, and drop it on the floor.”)

1 point each:

Drawing – Copy a design (Copying 2 intersecting pentagons – all 10 angles must be present and two must intersect)

Reading – Read this statement and do exactly what it says (“Close your eyes”)

Repeating (Allow only 1 trial) – Repeat the phrase “No ifs, and or, buts”

Writing – Write a sentence (must contain subject, verb and must make sense; correct grammar and punctuation is not necessary)

Interpretation

  • 24-30: Normal range
  • 18-23: Mild cognitive impairment
  • 0-17: Severe cognitive impairment

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