MMSE - Mini-Mental State Examination Attention and Calculation Questions and Answers

Question 1

An examiner asks a patient to perform serial 7s, starting from 100. The patient responds: "93, 85, 78, 71, 64". How many points should be awarded for the Attention and Calculation section?

Accepted Answer

1 point

Answer

Points are awarded for each correct subtraction from the proper sequence (100, 93, 86, 79, 72, 65). In this case, only the first subtraction ('93') is correct. The subsequent answers are not correct, so only one point is given.

Question 2

If a patient is unable or unwilling to perform the serial 7s subtraction task, what is the standard alternative provided in the MMSE for this section?

Accepted Answer

Spell the word 'WORLD' backward.

Answer

The officially recognized alternative task for Attention and Calculation in the MMSE is to ask the patient to spell the word 'WORLD' backward (D-L-R-O-W).

Question 3

A patient is asked to spell 'WORLD' backward and gives the response: "D-L-O-R-W". Based on standard MMSE scoring, what is the correct score?

Accepted Answer

3 points

Answer

The score is the number of letters in the correct sequential position. The correct sequence is D-L-R-O-W. The patient correctly placed 'D' (1st position), 'L' (2nd position), and 'W' (5th position). The 'O' and 'R' were transposed. Therefore, the score is 3.

Question 4

Which of the following is a critical procedural step for the examiner when administering the Attention and Calculation section of the MMSE?

Accepted Answer

Stop the patient after they have provided five responses for the chosen task.

Answer

The MMSE protocol requires the examiner to stop the task after five subtractions (for serial 7s) or once five letters have been spelled (for 'WORLD' backward). Scoring is based on these five attempts. Administering both and taking the higher score is a suggested modification in some settings but not the standard procedure, and correcting the patient or allowing aids is not permitted.

Question 5

The Attention and Calculation section, whether using serial 7s or spelling 'WORLD' backward, primarily assesses which cognitive domain?

Accepted Answer

Attention and working memory

Answer

These tasks require the ability to concentrate and hold information in one's mind while performing mental operations. This is the definition of attention and working memory. While executive function is related, attention is the more specific domain being tested here.

MMSE - Mini-Mental State Examination Practice Test

MMSE - Mini-Mental State Examination Practice Test

MMSE - Mini-Mental State Examination Attention and Calculation Questions and Answers