Mini-Mental State Examination (MMSE)
30-point questionnaire assessing orientation, registration, attention, recall, and language. Standard cognitive screening tool.
How to use & interpret
The Mini-Mental State Examination (MMSE) is a 30-point bedside test of cognition covering orientation, registration, attention, recall, language and visuospatial copying. As a rough guide, 24–30 is considered normal, 18–23 mild and <18 more significant impairment, though interpretation must account for education, language and sensory impairment.
It is a screening and tracking tool, not a diagnosis of dementia, and is relatively insensitive to mild cognitive impairment and frontal/executive problems — where MoCA or ACE-III may be preferred. Note the MMSE is copyrighted.
Score interpretation
→ A score in this range does not exclude dementia (education, language and sensory impairment affect the MMSE). If concerns persist, refer to a memory assessment service (NICE NG97); keep as a baseline for future comparison
→ The MMSE alone does not diagnose cognitive impairment or dementia. If not yet assessed: memory service referral; bloods for reversible causes (FBC, U&E, LFTs, TFTs, B12, folate, glucose, calcium); safety (driving, finances). If dementia is diagnosed: mild severity range (NICE TA217)
→ If dementia is diagnosed: moderate severity range (NICE TA217). Specialist dementia team; drug treatment per NICE TA217 / NG97; safeguarding; driving (DVLA); lasting power of attorney discussion
→ If dementia is diagnosed: severe range (NICE TA217). Specialist dementia care; care needs and carer support; advance care planning; safeguarding
Interpretation bands for the MMSE. Apply clinical judgement and local guidance.
Frequently asked questions
Does a normal MMSE rule out dementia?
No. The MMSE can miss mild cognitive impairment and executive dysfunction. If suspicion remains, use a more sensitive tool (MoCA, ACE-III) and a full assessment.
References
- Folstein MF, Folstein SE, McHugh PR. 'Mini-mental state'. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-198.
- Tombaugh TN, McIntyre NJ. The mini-mental state examination: a comprehensive review. J Am Geriatr Soc. 1992;40(9):922-935.
- NICE TA217. Donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer's disease. 2011.
Related
Curated clinical cross-links plus same-class fallbacks.
- Confusion Assessment Method (CAM) · Cognitive Assessment
- MoCA — Montreal Cognitive Assessment · Cognitive Assessment
- Mini-Mental State Examination (MMSE) · Cognitive Assessment
- 6-Item Cognitive Impairment Test (6CIT) · Cognitive Assessment
- Abbreviated Mental Test Score (AMT-10) · Cognitive Assessment
- Montreal Cognitive Assessment (MoCA) · Cognitive Assessment
- Progestogen-Only Pill (POP / Mini-pill) · Progestogen-Only Contraceptive (Oral)
- Donepezil · Acetylcholinesterase inhibitor (AChEI) — dementia
- Memantine · NMDA receptor antagonist — dementia
- Rivastigmine · Dual AChEI and BuChEI inhibitor — dementia
- Quetiapine (Elderly — Dementia Caution) · Atypical Antipsychotic
- Docusate sodium · Stool softener (anionic surfactant)
- Sepsis Screening and Sepsis Six · UK Sepsis Trust; NICE NG51; Surviving Sepsis Campaign 2021
- Unintentional Weight Loss Workup · NICE NG12; BSG
- Chronic Fatigue Workup · NICE NG206; BMJ Best Practice
- Lymphadenopathy Workup · NICE NG12; BMJ Best Practice
- Pre-op Medical Clearance · NICE NG45; ESC 2022
- Secondary Hypertension Workup · NICE NG136; ESH 2023
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.