The Mini Mental Status Exam is only a first step
If you’re worried that your older adult could be showing signs of Alzheimer’s disease or dementia, it’s important to not jump to any conclusions.
That’s because other medical conditions, medication side effects, or psychiatric issues could be causing dementia-like symptoms.
So, the first step is to have their primary doctor do a full physical and mental exam.
To look for possible cognitive issues, many doctors use a common screening test called the Mini Mental Status Exam (MMSE).
The Mini Mental Status Exam is a useful tool because it’s quick, simple, and can be used by any doctor without special training.
But it has significant limitations and cannot be used alone to make a diagnosis of Alzheimer’s or dementia.
We explain what the MMSE doesn't test for and why a too-quick diagnosis could be harmful to your older adult's health.
The MMSE doesn't catch all dementia symptoms
The MMSE can’t be used alone to diagnose Alzheimer’s or dementia because the majority of questions test only memory and recall.
Someone who knows what day it is, what a certain object is, or who can remember a short list of random things could do well on the test.
But that doesn’t mean they don’t have dementia. Some types, like Lewy body dementia, affect judgement far more than memory.
Some dementia symptoms the MMSE would miss include:
- Freely giving out bank account information to strangers
- Suddenly spending money like crazy when they’re always been frugal
- Making risky investment decisions when they’ve always been conservative investors
MMSE results don’t give enough information for accurate diagnosis or treatment
Non-geriatrics doctors often aren’t experienced in diagnosing Alzheimer’s or dementia.
Because of this, they might not know about the recommended testing and could jump to conclusions based solely on MMSE results.
As a caregiver, it’s important to know that it’s simply not possible to get an accurate dementia diagnosis in just one office visit.
A basic physical exam and MMSE screening doesn’t give enough information to declare a case of Alzheimer’s and prescribe medications like Namenda or Aricept.
Jumping to conclusions could cause your older adult to get the wrong treatment, which could be harmful to their health.
For example:
- Their dementia-like symptoms could be caused by a treatable medical condition like heart disease, vitamin deficiency, or kidney failure.
- Their symptoms could be caused by a medication side effect or drug interaction.
- They could have signs of depression or another psychiatric issue.
Different types of dementia can require different treatment.
Even if your older adult does have a form of dementia, how would the doctor know whether they have vascular dementia or Alzheimer’s or another type based solely on the MMSE?
They can't, which is why further testing and evaluation is needed for an accurate diagnosis.
Recommended for you:
- Testing for Dementia: The Mini Mental Status Exam
- How Is Dementia Diagnosed? A Geriatric Doctor Explains
- 7 Treatable Health Conditions with Symptoms Similar to Dementia
By DailyCaring Editorial Team
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About the Author
Connie Chow
Connie was a hands-on caregiver for her grandmother for 20 years. (Grandma made it to 101 years old!) She knows how challenging, overwhelming, and all-consuming caring for an older adult can be. She also knows how important support is — especially in the form of practical solutions, valuable resources, and self-care tips.
you don’t mention UTIs as a trigger for many dementia-like symptoms or the symptoms quickly worsening. I understood UTI would be among the top suspects for investigation.
My 93year old mother was diagnosed with MCI in 2014 after this MMSE test. She is now at stage 4-5 Alzheimers and her weekly deterioration is evident. Mother has carers twice a day but has no recollection of them, or anything they do. She insists that she is capable of looking after herself and her bungalow, refuses to wear hearing aids , glasses, slippers and use a walking stick. Her outlook on life is severely limited. My brother is her POA and I have arranged all her benefits to assist her living requirements. Mother has no idea of time,day, season or year. She thinks that she is in her 50’s and still wants to drive. Mother’s reality diminishes rapidly and we, her family, watch her struggle to understand her limitations. She will be 94 in January and despite being under the care of Adult Social Care Services, she refuses to go into a Care Home because mother still retains some ” capacity” to make her own decisions.
This is a challenging situation. Unfortunately, if she’s still determined to have capacity to make her own decisions, you cannot take over as Power of Attorney to make changes that will improve her health and safety. You may want to talk with the Adult Social Care Services agency and her doctor to let them know about her behavior and your concerns for her safety.