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The science behind the MMSE test: Why does education and age affect your score?
Mini–Mental State Examination (MMSE), or Folstein Test, is a 30-point questionnaire widely used in clinical and research settings, designed to measure cognitive impairment.This test is particularly common in medicine and related health fields as a tool for detecting dementia.At the same time, MMSE is also used to estimate the severity of cognitive impairment and its progress, as well as track individual cognitive changes over time, thus becoming an effective way to record individual responses to treatment.Although the purpose of MMSE is not to provide a diagnosis for any particular disease alone, its use has significant clinical value.
"The management of MMSE usually takes 5 to 10 minutes, examining features such as registration (repeated names), attention and calculation, recall, language, ability to follow simple instructions, and sense of direction."
The test was first introduced in 1975 by Folstein et al., with the original intention of distinguishing between organic and functional psychiatric patients.Nevertheless, it is very similar to the tests that have been used before, and even absorbs certain elements directly.MMSE is not a mental health status check, and its standard form is currently issued by Psychological Assessment Resources, based on the original concept from 1975 and has since undergone some minor modifications.
Pros and disadvantages of MMSE
The advantages of MMSE include the lack of specialized equipment or training for management, and its good effectiveness and reliability in the diagnosis and longitudinal evaluation of Alzheimer's disease.Due to its short management time and easy operation, MMSE is suitable for cognitive assessment in clinical clinics or hospital beds.However, there are certain flaws in the use of MMSE, the most significant problem is that it is affected by demographic factors; the influence of age and education level is the most obvious.
"Many critics point to the lack of sensitivity to mild cognitive impairment and failing to adequately distinguish between patients with mild Alzheimer's disease and normal."
The content of MMSE is highly colloquial and lacks sufficient projects to properly measure visual space or construct practical capabilities.Therefore, its effectiveness in detecting obstacles due to local damage remains questionable.In addition to MMSE, there are other tests that are widely used, such as the Hodkinson abbreviated mental test score, the Geriatric Mental State Examination and the General Practitioner Assessment of Cognition )wait.
Test features and explanation
The MMSE test includes simple questions and challenges, covering multiple areas: time and place of the exam, list of repeated words, math operations such as sequence seventy, language use and understanding, and basic motor skills.For example, a question requires the subject to copy two pentagonal figures, and the problem originated from an earlier Bender-Gestalt test.
"Any score of 24 or above (out of 30) indicates normal cognitive function; a score below this may indicate mild, moderate, or severe cognitive impairment."
It is worth noting that even a full score of 30 never ruled out the possibility of dementia, and there is no strong evidence to support this test as a single test to diagnose high-risk individuals.Although low score results may be closely related to the presence of dementia, other psychological disorders may also lead to abnormal MMSE tests.The presence of physical problems, if not properly documented, may also affect interpretation; for example, a patient may not be able to properly listen or read instructions for physical reasons, or may affect writing and drawing abilities due to motor deficits.
How to use MMSE
To maximize the utility of MMSE, Tombaugh and McIntyre (1992) gave some suggestions: MMSE should be used as a screening tool for cognitive impairment or an additional diagnostic tool, with low scores indicating that further evaluation is required.It should not be used as the only criterion for diagnosing dementia or distinguishing different forms of dementia.However, the score of MMSE can be used to classify the severity of cognitive impairment or to record sequence changes in patients with dementia.
Additionally, MMSE may also help differentiate between different types of dementia.For example, patients with Alzheimer's disease may have significantly lower sense of direction and memory performance in time and place than patients with Lewy body dementia, vascular dementia, or Parkinson's disease.
Copyright and updated version
MMSE was first published in 1975 and then underwent a series of copyright transfers.In particular, in 2001, MiniMental entered into an exclusive agreement with Psychological Testing Resources to grant it exclusive rights to issue, license and manage all media and languages of MMSE.Although there are many free versions of testing on the internet, Psychological Testing Resources companies claim that the official version is copyrighted and can only be ordered through their institutions.
Although it has been largely accepted, the application of MMSE has caused some controversy.Many researchers work hard to find alternative strategies for evaluating cognition.The subsequent revision of MMSE also demonstrates the continued demand and impact of this test.Do you also think that teachers and scholars should consider the subject's educational background and age when using MMSE?
