---
name: cognitive-assessment
description: 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 Assessment

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

- [FormExamples: cognitive-assessment](https://github.com/FormExamples/form-examples/tree/main/forms/cognitive-assessment) for the full implementation, clinical references, and worked examples.
- [[confusion-assessment-method]] for the acute-delirium-specific counterpart.
- [[gerontology-assessment]] for the broader elderly-patient assessment cognitive screening often feeds into.