MMSE - Mini-Mental State Examination Visuoconstructional Skills Questions and Answers — Questions and Answers
Question 1: A patient is asked to copy the intersecting pentagons on the MMSE. The patient draws two five-sided figures that are correctly shaped but are placed side-by-side and do not intersect. How should the examiner score this response?
- 1 point, because both figures have five sides.
- 0 points, because the figures must intersect. (Correct answer)
- 1 point, if the examiner prompts the patient to connect them.
- 0 points, unless the patient has a motor tremor.
Correct answer: 0 points, because the figures must intersect.
To receive one point for copying the design, the patient must draw two five-sided figures (10 angles total) that intersect to form a four-sided figure in the middle. If the figures do not intersect, a crucial part of the task is missing, and the score is zero.
Question 2: During the MMSE, an examiner administers the three-stage command: 'Take this paper in your right hand, fold it in half, and put it on the floor.' The patient takes the paper in their left hand, correctly folds it in half, and places it on their lap. How many points should be awarded?
- 3 points
- 2 points
- 1 point (Correct answer)
- 0 points
Correct answer: 1 point
The patient receives one point for each correctly executed step of the command. In this scenario, the patient only followed one step correctly: 'fold it in half.' They failed to use the correct hand ('right hand') and failed to place it in the correct location ('on the floor'). Therefore, they earn 1 out of a possible 3 points.
Question 3: A patient is given a piece of paper with the phrase 'CLOSE YOUR EYES' written on it and is instructed to read it and do what it says. The patient reads the phrase aloud correctly but makes no motion to close their eyes. What is the correct score?
- 1 point, because they demonstrated the ability to read.
- 0 points, but the examiner should give a verbal prompt to close their eyes.
- 1 point, as long as they read it without errors.
- 0 points, because the action was not performed. (Correct answer)
Correct answer: 0 points, because the action was not performed.
The point for this item is awarded for obeying the written command, not simply for reading it aloud. The patient must perform the action (closing their eyes) to demonstrate comprehension and praxis. Since the action was not performed, the score is zero.
Question 4: When evaluating a patient's response to the 'write a sentence' task, which of the following examples should be scored as correct (1 point)?
- The patient writes 'it is a nice day'. (Correct answer)
- The patient writes their own name and address.
- The patient copies the sentence 'CLOSE YOUR EYES' from the previous task.
- The patient writes the single phrase 'on the table'.
Correct answer: The patient writes 'it is a nice day'.
A score of 1 is given if the sentence is sensible and contains both a subject (e.g., 'it') and a verb (e.g., 'is'). Spelling and grammatical errors are ignored. Writing one's name, copying a sentence, or writing a phrase without a subject and verb does not meet the criteria for a spontaneously generated, complete sentence.
Question 5: The task of copying intersecting pentagons on the MMSE is included primarily to provide a quick assessment of which cognitive domain?
- Executive functioning
- Visuoconstructional skill (Correct answer)
- Abstract reasoning
- Long-term memory
Correct answer: Visuoconstructional skill
Visuoconstructional skill is the ability to perceive a complex object and then recreate it. This task directly tests the integration of visual perception with motor output, which is the core of visuoconstruction. While other domains like attention are involved, this is the primary target of the assessment.
Question 6: A patient is asked to write a sentence of their own choosing. They write, 'I walking home now'. According to standard MMSE scoring guidelines, how should this be scored?
- 0 points, because of the grammatical error ('walking' instead of 'am walking').
- 1 point, because the sentence contains a subject and verb and is sensible. (Correct answer)
- 0 points, because the sentence is too simple.
- 1 point, but only if the examiner corrects the grammar with the patient.
Correct answer: 1 point, because the sentence contains a subject and verb and is sensible.
The scoring criteria for the sentence writing task mandate that the sentence must be sensible and contain a subject ('I') and a verb ('walking'). The guidelines explicitly state that errors in grammar or spelling should be overlooked. Therefore, this response earns 1 point.
MMSE - Mini-Mental State Examination Visuoconstructional Skills Questions and Answers
A patient is asked to copy the intersecting pentagons on the MMSE.
The patient draws two five-sided figures that are correctly shaped but are placed side-by-side and do not intersect.
How should the examiner score this response?