MMSE Following a 3-Stage Command 3

Question 1

In clinical practice, which neurological condition most classically impairs the 3-stage command due to motor programming deficits while leaving comprehension relatively intact?

Accepted Answer

Apraxia

Answer

Apraxia disrupts the motor programming needed to execute learned purposeful movements, causing command failure despite intact comprehension.

Question 2

The standard 3-stage command paper used in MMSE administration should be:

Accepted Answer

A blank piece of paper provided by the examiner

Answer

The examiner provides a blank piece of paper as a neutral prop for the task to ensure standardization.

Question 3

A patient completes the first two stages of the 3-stage command and then asks, 'What do I do next?' How should this be scored?

Accepted Answer

Give credit for the two completed stages only, without prompting

Answer

Prompting is not allowed; the patient receives credit for stages independently completed, and the third stage scores zero if prompting was required.

Question 4

Which stage of the 3-stage command do patients with mild cognitive impairment most commonly fail first?

Accepted Answer

Placing it on the floor

Answer

The final stage (placing the paper on the floor) is most often missed because working memory decay causes loss of the last instruction in a sequence.

Question 5

How does the 3-stage command differ from a 1-stage command in terms of cognitive demands?

Accepted Answer

A 3-stage command additionally taxes working memory and executive sequencing

Answer

Multi-step commands require simultaneous retention of the full sequence in working memory and executive control to carry out steps in order.

MMSE - Mini-Mental State Examination Practice Test

MMSE - Mini-Mental State Examination Practice Test

MMSE Following a 3-Stage Command 3