MMSE Recall of Words 5 — Questions and Answers
Question 1: A patient denies remembering any words but, when given category cues, recalls all three correctly. What does this pattern suggest?
- Retrieval difficulty with intact storage, suggesting subcortical or frontal pathology rather than hippocampal amnesia (Correct answer)
- Complete memory failure consistent with Alzheimer's disease
- The patient is malingering
- The MMSE was administered incorrectly
Correct answer: Retrieval difficulty with intact storage, suggesting subcortical or frontal pathology rather than hippocampal amnesia
Intact cued recall with failed free recall indicates the memory trace was stored but retrieval is impaired, a pattern common in subcortical dementias and frontal lobe dysfunction.
Question 2: How does the MMSE word recall task differ from a recognition memory test?
- Recall requires generating the word without external prompts, while recognition requires identifying a word among choices (Correct answer)
- Recall is easier than recognition for most patients
- Recognition tests are not used in dementia evaluation
- Both tasks are identical in their cognitive demands
Correct answer: Recall requires generating the word without external prompts, while recognition requires identifying a word among choices
Free recall demands active retrieval with no external cues, whereas recognition provides the target word among foils and requires only identification.
Question 3: Which MMSE cutoff score is most commonly used in the US to indicate possible dementia?
- 23 or below out of 30 (Correct answer)
- 15 or below out of 30
- 27 or below out of 30
- 10 or below out of 30
Correct answer: 23 or below out of 30
A total MMSE score of 23 or below (out of 30) is widely used as a threshold suggesting possible cognitive impairment requiring further evaluation.
Question 4: A 90-year-old patient recalls 1 of 3 words. Before concluding cognitive impairment, the clinician should consider:
- Age-adjusted norms, because recall performance normally declines with advanced age (Correct answer)
- That any missed word always indicates dementia
- Administering the test again immediately to confirm
- Reporting the patient for elder neglect
Correct answer: Age-adjusted norms, because recall performance normally declines with advanced age
Normative recall performance decreases with age, so scores must be interpreted against age-matched reference data rather than universal cutoffs.
Question 5: Which medication class most commonly causes transient word recall impairment that can mimic dementia on MMSE testing?
- Benzodiazepines (Correct answer)
- Statins
- Antihypertensives
- Proton pump inhibitors
Correct answer: Benzodiazepines
Benzodiazepines cause sedation and anterograde amnestic effects that can significantly impair encoding and recall, producing falsely low MMSE scores.
Question 6: What is the clinical term for the specific inability to form new long-term memories, such as retaining MMSE words after a delay?
- Anterograde amnesia (Correct answer)
- Retrograde amnesia
- Procedural amnesia
- Source amnesia
Correct answer: Anterograde amnesia
Anterograde amnesia is the inability to encode new memories after the onset of injury or disease, directly impairing retention of newly learned information.
Question 7: In standardized MMSE administration, which of the following actions by the examiner would invalidate the word recall score?
- Reminding the patient of the words during the intervening tasks (Correct answer)
- Telling the patient how many words there are before recall
- Using a stopwatch to time the delay precisely
- Recording the number of registration trials needed
Correct answer: Reminding the patient of the words during the intervening tasks
Any reminder of the words during the intervening period contaminates the recall test by providing additional rehearsal opportunities, invalidating the memory assessment.
MMSE Recall of Words 5
A patient denies remembering any words but, when given category cues, recalls all three correctly.
What does this pattern suggest?