The Mini‐Mental State Examination: A Comprehensive Review

Tombaugh, Tom N.; McIntyre, Nancy J.

doi:10.1111/j.1532-5415.1992.tb01992.x

Cited by 5,152Dementia and Cognitive Impairment ResearchPsychological Testing and AssessmentHistorical and Modern Theater Studies

The Mini‐Mental State Examination: A Comprehensive Review

Tombaugh, Tom N., McIntyre, Nancy J.·1992·Journal of the American Geriatrics Society

DOI 10.1111/j.1532-5415.1992.tb01992.x

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Abstract

Objective: The purpose of this paper is to provide a comprehensive review of information accumulated over the past 26 years regarding the psychometric properties and utility of the Mini‐Mental State Examination (MMSE). Participants: The reviewed studies assessed a wide variety of subjects, ranging from cognitively intact community residents to those with severe cognitive impairment associated with various types of dementing illnesses. Main Outcome Measures: The validity of the MMSE was compared against a variety of gold standards, including DSM‐III‐R and NINCDS‐ADRDA criteria, clinical diagnoses, Activities of Daily Living measures, and other tests that putatively identify and measure cognitive impairment. Results: Reliability and construct validity were judged to be satisfactory. Measures of criterion validity showed high levels of sensitivity for moderate‐to‐severe cognitive impairment and lower levels for mild degrees of impairment. Content analyses revealed the MMSE was highly verbal, and not all items were equally sensitive to cognitive impairment. Items measuring language were judged to be relatively easy and lacked utility for identifying mild language deficits. Overall, MMSE scores were affected by age, education, and cultural background, but not gender. Conclusions: In general, the MMSE fulfilled its original goal of providing a brief screening test that quantitatively assesses the severity of cognitive impairment and documents cognitive changes occurring over time. The MMSE should not, by itself, be used as a diagnostic tool to identify dementia. Suggestions for the clinical use of the MMSE are made.

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Users with severe cognitive impairment (MMSE score <18) may still be able to use these systems effectively (performance index >50%) if their level of linguistic skills is normal (Robertson Dysarthria Profile = 4), which somehow compensates for the cognitive difficulties.
“Users with severe cognitive impairment (MMSE score <18) [36] may still be able to use these systems effectively (performance index >50%) if their level of linguistic skills is normal (Robertson Dysarthria Profile = 4) [29], which somehow compensates for the cognitive difficulties.”
From Investigating the Accessibility of Voice Assistants With Impaired Users: Mixed Methods Study (2020) · cites this paper as [36]
MMSE results are sensitive to age, level of education and cultural background, but not to gender.
“The results are sensitive to age, level of education and cultural background, but not to gender (Tombaugh and McIntyre 1992).”
From Effectiveness of a training programme based on acceptance and commitment therapy aimed at older adults – no moderating role of cognitive functioning (2021) · cites this paper as Tombaugh and McIntyre 1992
The decline in MMSE generally parallels that of more detailed testing.
“Nevertheless, the decline in MMSE generally parallels that of more detailed testing55.”
From Large-scale proteomic analysis of human brain identifies proteins associated with cognitive trajectory in advanced age (2019) · cites this paper as [55]
The MMSE/3MS has a limited ability to detect changes in specific cognitive domains such as attention and processing speed.
“This instrument (which was designed as a tool for assessing global cognitive function) has a limited ability to detect changes in specific cognitive domains such as attention and processing speed [17, 82].”
From Cognitive decline and dementia in diabetes—systematic overview of prospective observational studies (2005) · cites this paper as [17]

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Untitled work
Hart (1991) · doi:10.1002/1097-4679(199107)47:4

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The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment
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Poor Cognitive Function and Risk of Severe Hypoglycemia in Type 2 Diabetes
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Authors: Tombaugh, T. N., & McIntyre, N. J.
Affiliations: Carleton University (CA)
Venue: Journal of the American Geriatrics Society
Publisher: Wiley
Published: 1992-09
Volume: 40
Issue: 9
Pages: 922-935
ISSN: 0002-8614 (ISSN-L)
1532-5415
DOI: 10.1111/j.1532-5415.1992.tb01992.x
OpenAlex: W2109140840
Cited by: 5,152
References: 161
Citations by year: 2026: 207 · 2025: 257 · 2024: 233 · 2023: 231 · 2022: 239 · 2021: 283 · 2020: 279 · 2019: 271 · 2018: 257 · 2017: 232 · 2016: 222 · 2015: 182 · 2014: 195 · 2013: 166 · 2012: 179
FWCI: 6.28
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 8273 d)
Locations: Journal of the American Geriatrics Society (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health
National Institute of Mental Health
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
Keywords: Mini-Mental State Examination, cognitive screening, dementia diagnosis, psychometric properties, criterion validity, construct validity, reliability statistics, language assessment, NINCDS-ADRDA criteria, DSM-III-R
MeSH terms: Activities of Daily Living, Age Factors, Aged, Cognition Disorders, Dementia, Female, Humans, Probability, Psychiatric Status Rating Scales, Psychological Tests, Psychometrics, Sensitivity and Specificity, Severity of Illness Index, Sex Factors, Reproducibility of Results

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The Mini‐Mental State Examination: A Comprehensive Review

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