MMSE Registration of Words 5 — Questions and Answers
Question 1: A patient with moderate hearing loss misses one of the three registration words due to poor auditory acuity. How should the examiner proceed?
- Score the missed word as 0 and continue
- Repeat the missed word louder or use a hearing amplifier, then proceed with the standard protocol (Correct answer)
- Skip the registration section and note 'unable to test'
- Replace the missed word with a non-verbal stimulus
Correct answer: Repeat the missed word louder or use a hearing amplifier, then proceed with the standard protocol
Sensory accommodations such as speaking louder or using amplification devices are appropriate to ensure hearing loss does not confound the memory assessment.
Question 2: In the context of MMSE registration, what does 'encoding' refer to?
- Writing the words in a coded format
- The neural process of taking in and forming a memory trace for the presented words (Correct answer)
- Repeating the words in reverse order
- Translating the words into a visual image
Correct answer: The neural process of taking in and forming a memory trace for the presented words
Encoding is the cognitive process by which new information is converted into a memory trace that can later be stored and retrieved.
Question 3: Which MMSE section is directly dependent on successful performance in the registration section?
- Orientation to time
- Three-stage command
- Delayed word recall (Correct answer)
- Spelling 'world' backwards
Correct answer: Delayed word recall
Delayed word recall tests whether the patient can retrieve the exact three words introduced during registration; a failure to register them makes recall impossible.
Question 4: A demented patient requires all 6 repetition trials during registration and still only learns 2 of 3 words. Which statement best characterizes this performance?
- It is within normal limits for age
- It suggests significant short-term memory impairment that warrants further evaluation (Correct answer)
- It is a normal finding in patients over age 65
- It indicates the examiner used invalid words
Correct answer: It suggests significant short-term memory impairment that warrants further evaluation
Needing multiple trials to learn fewer than three words is clinically significant and consistent with short-term memory impairment requiring further evaluation.
Question 5: Which of the following best explains why the three MMSE registration words are presented at a rate of approximately one per second?
- To prevent the patient from writing the words down
- To keep each word in the phonological loop long enough for initial encoding without excessive rehearsal time (Correct answer)
- To match the natural rate of aural information processing mandated by law
- To reduce the total administration time
Correct answer: To keep each word in the phonological loop long enough for initial encoding without excessive rehearsal time
A paced presentation keeps each word in working memory's phonological loop while limiting the opportunity for elaborative rehearsal that could confound the test.
Question 6: A patient correctly repeats the three registration words and then, unprompted, repeats them aloud three more times. What effect does this have on the registration score?
- The score increases by one point for each additional correct repetition
- The score remains 3/3; additional repetitions do not add or subtract points (Correct answer)
- The score is reduced because the patient deviated from instructions
- The trial must be repeated under controlled conditions
Correct answer: The score remains 3/3; additional repetitions do not add or subtract points
The registration score is fixed at the number of words correctly repeated on the first trial; spontaneous additional repetitions do not alter the score.
Question 7: Which statement accurately compares MMSE registration to a digit span forward task?
- Both assess the same type of verbal short-term memory but registration uses words while digit span uses numbers (Correct answer)
- Digit span forward has a maximum of 3 points like MMSE registration
- MMSE registration is a measure of processing speed, unlike digit span
- Both tasks allow unlimited repetition trials without affecting the score
Correct answer: Both assess the same type of verbal short-term memory but registration uses words while digit span uses numbers
Both tasks tap verbal short-term memory and phonological loop capacity, but they differ in stimulus type (words vs. digits) and in scoring structure.
MMSE Registration of Words 5
A patient with moderate hearing loss misses one of the three registration words due to poor auditory acuity.
How should the examiner proceed?