MMSE Registration of Words 3 — Questions and Answers
Question 1: In standard MMSE administration, what instruction is typically given to the patient before presenting the three registration words?
- 'Write down these words as I say them.'
- 'I am going to name three objects. After I have said them, I want you to repeat them.' (Correct answer)
- 'Spell each word backwards when I am done.'
- 'Raise your hand each time you hear a word.'
Correct answer: 'I am going to name three objects. After I have said them, I want you to repeat them.'
The standard instruction alerts the patient that they will need to repeat the words immediately after the examiner names them.
Question 2: Which cognitive domain is primarily assessed by the MMSE registration task?
- Executive function
- Visuospatial ability
- Immediate memory and attention (Correct answer)
- Language fluency
Correct answer: Immediate memory and attention
Registration measures the patient's ability to immediately encode and hold new information, reflecting immediate memory and attention.
Question 3: A clinician notices a patient silently mouthing the words during registration trials beyond the first. Why might the clinician permit this?
- It is a standard scoring requirement
- Sub-vocal rehearsal can aid encoding and is generally acceptable (Correct answer)
- It adds points to the registration score
- It indicates the patient is malingering
Correct answer: Sub-vocal rehearsal can aid encoding and is generally acceptable
Sub-vocal rehearsal is a normal memory strategy and does not invalidate the registration task as long as the patient repeats the words aloud for scoring.
Question 4: A patient correctly repeats all three words on the first registration trial. What maximum score does this yield for the entire registration section?
- 1
- 2
- 3 (Correct answer)
- 6
Correct answer: 3
The registration section is worth a maximum of 3 points, one for each word correctly repeated on the first trial.
Question 5: After a patient scores 0 on registration despite three additional trials, what should the examiner do?
- Skip the delayed recall section entirely
- Continue attempting until the patient learns the words, up to the 6-trial maximum (Correct answer)
- Substitute easier words and restart the registration section
- End the examination immediately
Correct answer: Continue attempting until the patient learns the words, up to the 6-trial maximum
The examiner should continue repeating the words up to the limit of 6 total trials to give the patient the best chance of learning them for later recall.
Question 6: Which of the following patients is MOST likely to score full marks on MMSE registration but still show significant impairment on delayed recall?
- A patient with isolated attention deficit
- A patient with early Alzheimer's disease affecting hippocampal consolidation (Correct answer)
- A patient with expressive aphasia
- A patient with visuospatial neglect
Correct answer: A patient with early Alzheimer's disease affecting hippocampal consolidation
Early Alzheimer's disease can spare immediate repetition (registration) while severely impairing the hippocampal consolidation needed for delayed recall.
Question 7: During registration, the examiner presents the words 'apple,' 'penny,' and 'table.' The patient repeats 'apple,' 'penny,' and 'chair.' What is the registration score?
- 1
- 2 (Correct answer)
- 3
- 0
Correct answer: 2
Only 'apple' and 'penny' were correctly repeated; 'chair' is not one of the target words, so the score is 2.
MMSE Registration of Words 3
In standard MMSE administration, what instruction is typically given to the patient before presenting the three registration words?