Best of 2024: The Mini Mental Status Exam: 30 Question Dementia Screening Tool

By Connie Chow, Founder at DailyCaring

There’s a commonly used 30 question dementia test

If you’re concerned because you think your older adult might be showing signs of Alzheimer’s disease, dementia, or mild cognitive impairment, the first step is to visit their primary doctor for a full check-up.

If there aren’t any obvious causes of dementia-like symptoms, like a urinary tract infection or other treatable health condition, many doctors use a cognitive screening test called the Mini Mental Status Exam (MMSE) to check for possible cognitive issues.

Some people think of this as the clock drawing test.

We explain how the MMSE works, why it can’t be used alone to diagnose dementia, and what to watch out for at memory test events.

How the Mini Mental Status Exam works

The MMSE is commonly used because it only takes 5 – 10 minutes and doctors or nurses don’t need any equipment or special training.

This test for dementia has 30 questions, each worth 1 point. These questions test memory, orientation, and math skills.

The MMSE test includes questions that measure:

• Sense of date and time
• Sense of location
• Ability to remember a short list of common objects and later, repeat it back
• Attention and ability to do basic math, like counting backward from 100 by increments of 7
• Ability to name a couple of common objects
• Complex cognitive function, like asking someone to draw a clock

The grading scale is:

• 25 or more points = no cognitive impairment detected
• 21-24 points = mild cognitive impairment
• 10-20 points = moderate cognitive impairment
• 0-9 points = severe cognitive impairment

If someone gets MMSE scores in the 0 to 20 range, it can indicate cognitive impairment.

But it doesn’t mean that they have dementia. One cognitive screening test can’t be used alone for diagnosing dementia.

What it does mean is that further evaluation is needed – more physical and cognitive tests should be done to better understand what’s causing the cognitive issues.

The MMSE alone can’t be used for a dementia diagnosis

No matter what they score on the Mini Mental Status Exam, don’t consider those results to be the final answer. 

Many factors can influence someone’s MMSE score, both positively and negatively. This is only one of many dementia diagnosis tools.

The MMSE is a useful cognitive screening tool, but can’t be used to diagnose dementia or Alzheimer’s disease because there are many factors that could affect the test results.

Complicating factors include:

• Physical injuries
• Physical conditions like sleep apnea, which can cause memory or other cognitive problems
• Conditions like depression
• Trouble with math, especially for those with limited education
• Trouble with language, especially for non-native English speakers, those who don’t speak any English, and people with limited education
• Having a form of dementia that doesn’t significantly affect memory, like Lewy Body dementia

Experts warn against one-time memory test events

You may see memory screenings offered at shopping malls or health fairs.

Experts recommend avoiding those tests, even if they use the MMSE.

Taking a quick test like these without a full medical evaluation isn’t an effective dementia screening and is more likely to cause unnecessary fear and worry.

Next Step  Find out why the MMSE alone isn’t enough for a dementia diagnosis

Recommended for you:

• How Is Dementia Diagnosed? A Geriatric Doctor Explains
• Signs of Alzheimer’s or Normal Forgetfulness?
• What Is Alzheimer’s Disease? Symptoms, Causes, Treatments

Image: Seniors Aloud

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.