MMSE Detection 3 — Questions and Answers
Question 1: Which MMSE task requires a patient to follow a three-step verbal command?
- Attention and calculation
- Language – comprehension (Correct answer)
- Recall
- Orientation
Correct answer: Language – comprehension
The three-step command ('Take a paper in your right hand, fold it in half, and put it on the floor') is part of the Language comprehension section.
Question 2: The MMSE registration task asks the patient to repeat three words. What does failure to register all three words indicate?
- Intact short-term memory
- Impaired attention or encoding (Correct answer)
- Normal aging
- Good long-term recall
Correct answer: Impaired attention or encoding
Inability to register all three words suggests impaired attention or encoding, which is foundational for subsequent recall testing.
Question 3: A clinician suspects Lewy body dementia rather than Alzheimer's. Which MMSE domain impairment pattern is more characteristic of Lewy body dementia?
- Primarily memory impairment
- Primarily visuospatial impairment (Correct answer)
- Primarily language impairment
- Primarily orientation impairment
Correct answer: Primarily visuospatial impairment
Lewy body dementia tends to show early and disproportionate visuospatial deficits compared to Alzheimer's disease.
Question 4: How many points are possible on the MMSE recall section?
- 5
- 3 (Correct answer)
- 7
- 4
Correct answer: 3
The recall section tests memory of three previously registered words, so the maximum score is 3 points.
Question 5: Which alternative brief cognitive screen is most commonly used alongside the MMSE to improve detection accuracy?
- Beck Depression Inventory
- Montreal Cognitive Assessment (MoCA) (Correct answer)
- Hamilton Anxiety Scale
- PHQ-9
Correct answer: Montreal Cognitive Assessment (MoCA)
The MoCA is frequently used alongside or instead of the MMSE because it is more sensitive to mild cognitive impairment.
Question 6: What does the MMSE's pentagon-copying task specifically detect?
- Verbal fluency deficits
- Visuospatial and constructional impairment (Correct answer)
- Short-term memory loss
- Executive function deficits
Correct answer: Visuospatial and constructional impairment
Copying intersecting pentagons on the MMSE evaluates visuospatial perception and constructional ability.
Question 7: Which condition can elevate MMSE scores and mask true cognitive decline, leading to delayed dementia detection?
- Hypothyroidism
- High premorbid intellectual ability (Correct answer)
- Vitamin B12 deficiency
- Chronic pain
Correct answer: High premorbid intellectual ability
High premorbid intellectual ability allows patients to compensate on MMSE tasks, artificially inflating scores despite underlying neurodegeneration.
MMSE Detection 3
Which MMSE task requires a patient to follow a three-step verbal command?