MMSE Evaluation 3 — Questions and Answers
Question 1: Which MMSE subsection specifically evaluates a patient's ability to follow a three-step verbal command?
- Orientation
- Attention and calculation
- Language — comprehension (Correct answer)
- Recall
Correct answer: Language — comprehension
The three-step command ('Take the paper in your right hand, fold it in half, and put it on the floor') is part of the Language subsection assessing comprehension.
Question 2: A patient with severe aphasia attempts the MMSE. Which aspect of standard evaluation is most compromised?
- The drawing task
- Virtually all verbal response items, making the score unreliable (Correct answer)
- Only the orientation questions
- The recall task exclusively
Correct answer: Virtually all verbal response items, making the score unreliable
Severe aphasia impairs verbal communication across most MMSE items, making the standard score an unreliable measure of cognitive status for aphasic patients.
Question 3: What does a score of 10-19 on the MMSE most commonly indicate?
- Normal aging
- Mild cognitive impairment
- Moderate dementia (Correct answer)
- Severe dementia
Correct answer: Moderate dementia
MMSE scores of 10-19 are generally classified as moderate dementia, indicating significant but not total loss of cognitive function.
Question 4: During MMSE evaluation, a patient is asked to spell 'WORLD' backwards. The patient spells 'DLROW' — what is their score for this item?
- 0 points
- 2 points
- 5 points (Correct answer)
- 3 points
Correct answer: 5 points
Spelling WORLD backwards correctly as DLROW earns the full 5 points for the attention and calculation subsection when the serial 7s alternative is not used.
Question 5: Why is it important to document the specific conditions under which an MMSE was administered?
- For billing purposes only
- To enable valid score comparisons across time and examiners (Correct answer)
- To determine which medications to prescribe
- The conditions do not affect score interpretation
Correct answer: To enable valid score comparisons across time and examiners
Documenting conditions (time of day, presence of pain, visual aids used, etc.) ensures that serial scores are comparable and changes reflect true cognitive change.
Question 6: Which patient population tends to have the highest rate of false-positive MMSE impairment despite intact cognition?
- Young adults with no education
- Elderly individuals with very high educational attainment
- Elderly individuals with limited formal education or low literacy (Correct answer)
- Bilingual middle-aged adults
Correct answer: Elderly individuals with limited formal education or low literacy
Elderly individuals with limited education or low literacy often score lower on the MMSE due to unfamiliarity with certain tasks, not actual cognitive impairment.
Question 7: In evaluating the MMSE recall subsection, what is the examiner testing by asking the patient to repeat three words after a delay?
- Immediate memory span
- Delayed free recall, reflecting hippocampal-dependent memory (Correct answer)
- Procedural memory
- Semantic memory for common objects
Correct answer: Delayed free recall, reflecting hippocampal-dependent memory
The delayed recall task specifically measures hippocampal-dependent memory consolidation, which is among the earliest functions impaired in Alzheimer's disease.
MMSE Evaluation 3
Which MMSE subsection specifically evaluates a patient's ability to follow a three-step verbal command?