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The Mini-Mental State Examination: pitfalls and limitations
  1. Emma Devenney1,2,3,
  2. John R Hodges1,4
  1. 1 Frontier, Neuroscience Research Australia, Sydney, Australia
  2. 2 Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
  3. 3 Brain and Mind Centre, University of Sydney, Sydney, Australia
  4. 4 School of Medical Sciences, University of New South Wales, Sydney, Australia
  1. Correspondence to Dr Emma Devenney, Neuroscience Australia, Barker Street, Randwick, Sydney 2035, Australia; e.devenney{at}

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The Mini-Mental State Examination (MMSE) first appeared in 1975 having been developed as a screening tool for patients with dementia and psychiatric disorders in an inpatient setting.1 Folstein and colleagues did not envisage the global domination that this simple clinical tool would achieve. They clearly state in their seminal paper that ‘the MMS cannot be expected to replace a complete clinical appraisal in reaching a final diagnosis in any individual patient’. But, as frequently happens, this major caveat was quickly forgotten, and, over the course of the next 40 years, this brief 30-item examination gained immense fame among clinicians as a quick and easy method to diagnose dementia. The MMSE is strongly influenced by non-cognitive domains; it does not reliably translate across cultures, as the results are likely to be confounded by language, levels of literacy, and cultural and ethical norms. Despite this, the MMSE has been …

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  • Contributors ED and JRH contributed to the conception and design of the work and drafting and revising the manuscript; they approve the final version and agree to be accountable for the work.

  • Funding This work was supported by funding to Forefront, a collaborative research group dedicated to the study of frontotemporal dementia and motor neurone disease, from the National Health and Medical Research Council of Australia programme grant (No 1037746) and the Australian Research Council Centre of Excellence in Cognition and its Disorders Memory Node (No CE110001021). ED is supported by a UNSW PhD scholarship and the Motor Neurone Disease Association UK.

  • Competing interests None declared.

  • Provenance and peer review Commissioned. Externally peer reviewed. This paper was reviewed by Martin Rossor, London, UK.

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