The Mini Mental Status Exam (MMSE) Patient: ____________________ Physical: ________________ Date: ____________

Maximum

Score

5 5

( (

) )

3

(

)

5

(

)

3

(

)

2 1 3

( ( (

) ) )

Orientation: What is the (year) (season) (day) (month)? Where are we (state) (country) (town) (hospital) (floor)? 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/she learns all 3. Count trials and record. Trials____________ Attention and Calculation: Serial 7’s. 1 point for each correct answer. Stop after 5 answers. Alternatively spell “WORLD” backward. Recall: Ask for the 3 object repeated above. Give 1 point for each correct answer. Language: Name a pencil and watch. Repeat the following “No ifs, ands, or buts” Follow a 3-stage command: Take a paper in your hand, fold it in half, and put it on the floor”

1 1 1

( ( (

) ) )

Read and obey the following: CLOSE YOUR EYES Write a sentence Copy the design shown:

______ Total Score ASSESS level of consciousness along continuum______________ Alert Drowsy Stupor Coma

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