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Managing the cognitive impairment of elderly patients using the Mini Mental State Examination (MMSE)
  1. E Cheah,
  2. S Rajaram,
  3. H C Chua,
  4. H L Ng,
  5. H M Tim,
  6. S Cinnappan and
  7. S T Lim
  1. Khoo Teck Puat Hospital, Singapore


Introduction Cognitive impairment is no longer considered a normal and inevitable change of ageing. Although older adults are at a higher risk than the rest of the population, changes in cognitive function often call for prompt and aggressive function. In older patients cognitive functioning is especially likely to decline during illness or injury. The nurses' assessment of an older adult's cognitive status is instrumental in identifying early changes in physiological status, ability to learn and learning responses to treatment.

Method The Mini Mental State Examination created by Folstein et al in 1975 (MMSE) is a tool that can be used to systematically and thoroughly assess mental status. It is a 11 –question measure that tests five areas of cognitive function: orientation, registration, attention and calculation, recall and language. The maximum score is 30. A score of 23 or lower is indicative of cognitive impairment. The MMSE only takes 5–10 min to administer and is therefore practical to use repeatedly and routinely.

Result 10 patients were assessed. 3 of the patients were found to have problems with orientation, 2 of them with registration, 2 of them with attention and calculation, 2 of them with recall and 1 of them with language. 9 patients out of the 10 were assessed and had to be placed in nursing homes and this was reflected in their application for nursing homes. Assessment of the older adult's cognitive function is best achieved when it is done routinely, systematically and thoroughly.

Conclusion The MMSE is effective as a screening instrument to separate patients with cognitive impairment from those without it. In addition when used repeatedly the instrument is able to measure changes in cognitive status that may benefit from intervention.

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