Mini-Mental State




Copyright © 1975 Published by Elsevier Science Inc. All rights reserved.
“Mini-mental state”
A practical method for grading the cognitive state of patients for the clinician


Marshal F. Folstein, Susan E. Folstein and Paul R. McHugh
Department of Psychiatry, The New York Hospital-Cornell Medical Center, Westchester Division, White Plains, New York 10605, U.S.A.
Department of Psychiatry, University of Oregon Medical School, Portland, Oregon 97201, U.S.A.
Received 17 December 1973;  revised 25 November 1974.  Available online 7 June 2002.



Reprint request to M.F.F. now at Department of Psychiatry and Behavioral Science, Johns Hopkins Hospital, Baltimore, Md 21205, USA.


Journal of Psychiatric Research
Volume 12, Issue 3, November 1975, Pages 189-198


MMSE의 original article을 구했다.
보통 옛날 저널들은 학교에서 구독을 하더라도 몇년도 이전의 것들은 따로이 돈을 내고 받아야 하는데..
요행히도 구하게 되었다.


전에도 AJP에서 퍼온글이 있긴 하지만.. 경각심을 일깨우기 위해 다시한번 더 적어본다.

MMSE는 이 Journal of Psychiatric Research에 처음으로 실리게 되었고, 이 저널은 Elsevier라는 회사로 팔리게 되어 저작권 또한 넘어가게 되었다. 마침내 이 저작권은 MiniMental LLC라는 회사가 취득하게 되었고, MMSE의 모든 형태의 시험지, 안내서, 프로그램등은 PAR(Psychological Assessment Resources, Inc.)라는 회사를 통해 팔리게 되었다.


MMSE를 쓰려면 한장에 1$라는 돈을 지불해야 한다. 하지만 아직 MMSE가 저작권이 있는 검사라는 사실을 아는 사람은 많지 않다. 특히 국내에는 더더욱…

PAR Inc.의 홈페이지에 가면 친절하게도 한글판도 번역해서 판매한다고 게시되어 있다.
MMSE-K, K-MMSE, MMSE-KC이건간에 모두다.. PAR의 저작권 이양을 받지 않은 이상은 모두 불법이다.
(MMSE 확장판은 모르겠다.)

뭐.. 언제부터 저작권 그렇게 잘 지켜왔냐고 반문하는 사람도 있을텐데.. 적어도.. ‘내가 불법을 자행하고 있소.’하는 태도는 자신을 방어해주지 못할 것이다.

혹여나.. 자신의 홈페이지에 올리신 분들은.. 모두 내리시길..
책을 쓰더라도.. 주의해서..


돈을 지불할 자신이 없다면, 연구목적에서의 사용이라 하더라도 MMSE는 더이상 사용하지 말아야 할 것이다. 언제이고 그 회사가 저작권에 대한 책임을 물을 경우에는 엄청난 손실이 뒤따를 것이기 때문에…


Folstein MF, Folstein SE, McHugh PR: “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12:189–198 [Medline]

Saint Louis University Mental Status (SLUMS) Examination


A New Cognitive Assessment Tool Shows Promise — and It’s Free

Professionals in social services have long used the Mini Mental Status Examination (MMSE) to assess cognitive impairment in older adults. Now, Saint Louis University researchers have developed a new screening tool, the Saint Louis University Mental Status Examination (SLUMS), that appears to work better at assessing mild cognitive impairment than the MMSE and is equally effective as a screen for moderate or severe cognitive impairment.


“This is good news for social workers and other social services practitioners, who are frequently asked to assess the cognitive capacity of older adults and their families,” said ASA member Scott Miyake Geron, who is an expert on assessment and director of the Institute for Geriatric Social Work at Boston University. “Because of their close involvement with clients, these practitioners are often more likely than other health professionals to be in a position to identify early signs of cognitive impairment. Unlike the MMSE, the SLUMS is freely available on the Web, which is another attractive feature.”


The Saint Louis University researchers used both MMSE and SLUMS to test 705 men who were at least 60 years old and who received treatment at the Geriatric Research Education Clinical Center of the Veterans Administration Hospital in St. Louis in 2003. The researchers found that while both tools detected dementia, only the SLUMS screening identified a group of patients as having mild cognitive problems.


“The development of an improved version of a measure long considered the gold standard of assessment is a reminder to all social services practitioners that advances in practice occur regularly,” Geron said. “It illustrates the importance of paying attention to the research and practice literature to stay abreast of new developments.”


The comparative study of SLUMS and MMSE appeared in the November 2006 issue of the American Journal of Geriatric Psychiatry. The researchers cautioned that while both tools are effective for basic screening, neither is a substitute for clinical assessment and neuropsychological testing to diagnose cognitive problems and dementia.



The SLUMS is similar in format, but it supplements the MMSE with enhanced tasks in the attention, calculation, recall, digit span, clock- drawing, and immediate recall areas. The clock-drawing test assesses executive function, one of the earliest forms of cognition affected in MNCD.

  1. What day of the week is it? (1 point for the right answer)

  2. What is the year? (1 point)

  3. What state are we in? (1 point)

  4. Please remember these five objects. I will ask you what they are later: apple, pen, tie, house, car. (No points yet)

  5. You have $100 and you go to the store and buy a dozen apples for $3 and a tricycle for $20.

    • How much did you spend? (1 point)
    • How much do you have left? (2 points)

  6. Please name as many animals as you can in one minute. (No point for naming 0-5; 1 point for naming 5-10; 2 points for naming 10-15; and 3 points for naming more than 15.)

  7. What were the five objects I asked you to remember? (1 point for each object remembered.)

  8. I am going to say a series of numbers and I would like you to give them to me backwards. For example, if I say 42, you would say 24.

    • 87 (0 points)
    • 649 (1 point)
    • 8537 (2 points)

  9. (Draw circle.) This circle represents a clock face. Please put in the hour markers and the time at ten minutes to eleven o’clock.

    • (2 points for hour markers labeled correctly)
    • (2 points for correct time)

  10. (Show a triangle, a square and a rectangle.) Please place an X in the triangle. (1 point)

  11. Which of those objects is the largest? (1 point)

  12. I am going to tell you a story. Please listen carefully because afterward, I’m going to ask you some questions about it.

    Jill was a very successful stockbroker. She made a lot of money in the stock market. She then met Jack, a devastatingly handsome man. She married him and had three children. They lived in Chicago. She then stopped working and stayed at home to bring up her children. When they were teenagers, she went back to work. She and Jack lived happily ever after.


    • What was the female’s name? (2 points)
    • When did she go back to work? (2 points)
    • What work did she do? (2 points)
    • What state did she live in? (2 points)


SCORING:
High school graduate: Normal: 27-30; Needs more evaluation: 20-26; Dementia: 1-19.
Less than high school diploma: Normal: 20-30; Needs more evaluation: 14-19; Dementia: 1-13.

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