MMSE - Mini-Mental State Examination Attention and Calculation Questions and Answers — Questions and Answers
Question 1: An examiner asks a patient to perform serial 7s, starting from 100. The patient responds: "93, 85, 78, 71, 64". How many points should be awarded for the Attention and Calculation section?
- 5 points
- 1 point (Correct answer)
- 3 points
- 0 points
Correct answer: 1 point
Points are awarded for each correct subtraction from the proper sequence (100, 93, 86, 79, 72, 65). In this case, only the first subtraction ('93') is correct. The subsequent answers are not correct, so only one point is given.
Question 2: If a patient is unable or unwilling to perform the serial 7s subtraction task, what is the standard alternative provided in the MMSE for this section?
- Recite the months of the year in reverse order.
- Count backward from 20 by 3s.
- Spell the word 'WORLD' backward. (Correct answer)
- Name as many animals as possible in one minute.
Correct answer: Spell the word 'WORLD' backward.
The officially recognized alternative task for Attention and Calculation in the MMSE is to ask the patient to spell the word 'WORLD' backward (D-L-R-O-W).
Question 3: A patient is asked to spell 'WORLD' backward and gives the response: "D-L-O-R-W". Based on standard MMSE scoring, what is the correct score?
- 2 points
- 5 points
- 4 points
- 3 points (Correct answer)
Correct answer: 3 points
The score is the number of letters in the correct sequential position. The correct sequence is D-L-R-O-W. The patient correctly placed 'D' (1st position), 'L' (2nd position), and 'W' (5th position). The 'O' and 'R' were transposed. Therefore, the score is 3.
Question 4: Which of the following is a critical procedural step for the examiner when administering the Attention and Calculation section of the MMSE?
- Administer both serial 7s and 'WORLD' backward and use the higher of the two scores.
- Stop the patient after they have provided five responses for the chosen task. (Correct answer)
- Correct the patient immediately after each incorrect subtraction to help them get back on track.
- Allow the patient to use a pen and paper to assist with their calculations.
Correct answer: Stop the patient after they have provided five responses for the chosen task.
The MMSE protocol requires the examiner to stop the task after five subtractions (for serial 7s) or once five letters have been spelled (for 'WORLD' backward). Scoring is based on these five attempts. Administering both and taking the higher score is a suggested modification in some settings but not the standard procedure, and correcting the patient or allowing aids is not permitted.
Question 5: The Attention and Calculation section, whether using serial 7s or spelling 'WORLD' backward, primarily assesses which cognitive domain?
- Long-term memory
- Visuospatial ability
- Executive function
- Attention and working memory (Correct answer)
Correct answer: Attention and working memory
These tasks require the ability to concentrate and hold information in one's mind while performing mental operations. This is the definition of attention and working memory. While executive function is related, attention is the more specific domain being tested here.
Question 6: What is the maximum possible score for the 'Attention and Calculation' portion of the Mini-Mental State Examination?
- 5 (Correct answer)
- 3
- 7
- 10
Correct answer: 5
The maximum score for this section is 5 points. This is consistent whether the patient performs the serial 7s task (one point for each of five correct subtractions) or spells 'WORLD' backward (one point for each of five correctly sequenced letters).
MMSE - Mini-Mental State Examination Attention and Calculation Questions and Answers
An examiner asks a patient to perform serial 7s, starting from 100.
The patient responds: "93, 85, 78, 71, 64".
How many points should be awarded for the Attention and Calculation section?