Folstein Mini Mental Status Examination
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3Folstein Mini-Mental Status Examination
Tools needed for completion: 2 pg. MMSE, wrist watch, pen, 4 blank pieces of paper
Student Name
Date
Client Initials
This section will be completed by instructor if comments are necessary.
Instructor Comments:
Orientation
Score
“What is today’s date?
Response
Day:
(1)
Date:
(1)
Month:
(1)
Year:
(1)
Season:
(1)
Where are we?
Place:
(1)
Floor:
(1)
City:
(1)
County:
(1)
State
(1)
Registration
•
Examiner will name 3 objects (1 second to say each – should be unrelated objects).(ex. Desk, penny,
apple)
•
Ask subject to repeat all three words; one point for each correct answer. Repeat as necessary until
subject learns all 3 objects (up to 6 trials):
Response
Score
Object 1:
(1)
Object 2:
(1)
Object 3:
(1)
Number of trials
Attention and Calculation
•
Ask subject to count backwards from 100 by 7:s (serials 7’s). One point for each correct answer up to
5. If subject cannot or will not perform this task, ask subject to spell “WORLD” backwards.
Score
93 or (D)
(1)
86 or (L)
(1)
79 or (R)
(1)
72 or (O)
(1)
65 or (W)
(1)
Implemented Fall 2008.
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Parent category: Medical