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Cognitive Assessment

Use when asked to administer, score, or explain a Cognitive Assessment — screening with the MMSE (Mini-Mental State Examination) — grounded in FormExamples/form-examples; distinct from confusion-assessment-method's acute-delirium focus.

Cognitive function screening using the MMSE (Mini-Mental State Examination) with functional impact assessment.

Scoring

Instrument: MMSE. Range 0–30.

  • 24–30 — normal cognition.
  • 18–23 — mild cognitive impairment.
  • 0–17 — severe cognitive impairment.

What it covers

Demographics; referral information; orientation (time and place); registration; attention and calculation; recall; language; repetition and commands; visuospatial ability; and functional history.

Cognitive assessment vs. confusion assessment

The MMSE screens for chronic, stable cognitive impairment (dementia- spectrum); Confusion Assessment Method screens specifically for acute, fluctuating delirium. A patient can score low on the MMSE due to baseline dementia while also being screened separately for a superimposed acute delirium — the two questions and instruments aren't interchangeable.

Common pitfalls

  • Using the MMSE score in isolation to diagnose dementia — it's a screening tool; a low score prompts further evaluation, not a standalone diagnosis.
  • Not accounting for education level and language — MMSE performance is influenced by educational background and whether the test is administered in the patient's first language; scores need that context to interpret correctly.
  • Confusing chronic cognitive impairment with acute confusion — see Confusion Assessment Method; conflating the two can miss a treatable acute cause (delirium) behind an apparent cognitive decline.

Learn more

View cognitive-assessment/SKILL.md on GitHub