Mini Mental State Exam (MMSE)
Description: Tests five areas of cognitive function: orientation, registration, attention and calculation, recall, and language.
Number of Items: 20
| Item | Question Wording | TILDA Variable |
|---|---|---|
| 1 | Please tell me what year is it? | PH121 |
| 2 | What season is it? | PH126 |
| 3 | What month is it? | PH122 |
| 4 | Can you tell me what day of the week it is? | PH123 |
| 5 | Can you tell me what today’s date is? | PH124 |
| 6 | What is the name of this country? | PH127 |
| 7 | What is the name of this county? | PH128 |
| 8 | What is the name of this city/town? | PH129 |
| 9 | What is this building? | PH130 |
| 10 | What floor are we on? | PH131 |
| 11 | I am going to say three words. You say them back after I stop. Now keep those words in mind. I am going to ask you to say them again in a few minutes. | PH132 |
| 12 | Now I’d like you to subtract 7 from 100. Then keep subtracting 7 from each answer until I tell you to stop. (Serial 7’s) | PH133 |
| 13 | Repeat 3 objects outlined in 'Registration' section. | PH134 |
| 14 | What were those three words I asked you to remember? | PH135 |
| 15 | Name a pencil and watch. | PH136 |
| 16 | Repeat the following “No ifs, ands, or buts”. | PH137 |
| 17 | “Take a paper in your hand, fold it in half, and put it on the floor.” | PH138 |
| 18 | Read and obey the following: CLOSE YOUR EYES | PH139 |
| 19 | Write a sentence. | PH140 |
| 20 | Copy the design shown | PH141 |
Scoring Method:
Each answer assigned a score of 1 if answered correctly. Scores range between 0-30.
0-17 - Severe cognitive impairment.
18 - 23 - Mild cognitive impairment.
24 - 30 - No cognitive impairment.
>25 - Decreased odds of dementia.
<21 - Increased odds of dementia.
Citation:
- Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-Mental State Examination (MMS, MMSE)
Example TILDA Papers:
Orr, J., Ward, M., Kenny, R. A., & McGarrigle, C. A. (2021). Mini-mental state examination trajectories after age 50 by religious affiliation and practice in Ireland. European journal of ageing, 18(4), 565–574. https://doi.org/10.1007/s10433-020-00597-0
May, P., De Looze, C., Feeney, J., Matthews, S., Kenny, R. A., & Normand, C. (2022). Do Mini-Mental State Examination and Montreal Cognitive Assessment predict high-cost health care users? A competing risks analysis in The Irish Longitudinal Study on Ageing. International journal of geriatric psychiatry, 37: 1-9 https://doi.org/10.1002/gps.5766
Code
foreach var of varlist ph121 ph126 ph122 ph123 ph124 ph127 ph128 ph129 ph130 ph131 ph132 ph133 ph134 ph135 ph136 ph137 ph138 ph139 ph140 ph141 {
recode `var' (-1=.)(97/99=.), gen(`var'score)
}
egen ph1334score = rowmax(ph133score ph134score)
egen mmsetotal_2 = rowtotal(ph121score ph126score ph122score ph123score ph124score ph127score ph128score ph129score ph130score ph131score ph132score ph1334score ph135score ph136score ph137score ph138score ph139score ph140score ph141score)
replace mmsetotal_2 = -1 if hh005 >1
replace mmsetotal = mmsetotal_2
gen COGmmse = .
replace COGmmse = mmsetotal if mmsetotal >=0
label variable COGmmse "Mini-Mental State Examination"score_src <- c(
"ph121","ph126","ph122","ph123","ph124","ph127","ph128","ph129","ph130",
"ph131","ph132","ph133","ph134","ph135","ph136","ph137","ph138","ph139",
"ph140","ph141"
)
for (v in score_src) {
out <- paste0(v, "score")
data[[out]] <- data[[v]]
bad <- !is.na(data[[out]]) &
(data[[out]] == -1 | (data[[out]] >= 97 & data[[out]] <= 99))
data[[out]][bad] <- NA_real_
}
# Best score between ph133 and ph134; rowmax ignores one missing value.
a <- data$ph133score
b <- data$ph134score
data$ph1334score <- ifelse(
is.na(a) & is.na(b),
NA_real_,
pmax(a, b, na.rm = TRUE)
)
mmse_items <- c(
"ph121score","ph126score","ph122score","ph123score","ph124score",
"ph127score","ph128score","ph129score","ph130score","ph131score",
"ph132score","ph1334score","ph135score","ph136score","ph137score",
"ph138score","ph139score","ph140score","ph141score"
)
# Stata egen rowtotal() ignores missing components and returns 0 if all are missing.
data$mmsetotal_2 <- rowSums(data[mmse_items], na.rm = TRUE)
data$mmsetotal_2[!is.na(data$hh005) & data$hh005 > 1] <- -1
# The Stata source replaces an existing mmsetotal with mmsetotal_2.
data$mmsetotal <- data$mmsetotal_2
data$COGmmse <- NA_real_
data$COGmmse[!is.na(data$mmsetotal) & data$mmsetotal >= 0] <-
data$mmsetotal[!is.na(data$mmsetotal) & data$mmsetotal >= 0]
attr(data$COGmmse, "label") <- "Mini-mental state examination"DO REPEAT src = ph121 ph126 ph122 ph123 ph124 ph127 ph128 ph129 ph130 ph131 ph132 ph133 ph134 ph135 ph136 ph137 ph138 ph139 ph140 ph141
/dst = ph121score ph126score ph122score ph123score ph124score ph127score ph128score ph129score ph130score ph131score ph132score ph133score ph134score ph135score ph136score ph137score ph138score ph139score ph140score ph141score.
COMPUTE dst = src.
RECODE dst (-1=SYSMIS) (97 THRU 99=SYSMIS).
END REPEAT.
COMPUTE ph1334score = MAX(ph133score, ph134score).
COMPUTE mmsetotal_2 = SUM(
ph121score, ph126score, ph122score, ph123score, ph124score,
ph127score, ph128score, ph129score, ph130score, ph131score,
ph132score, ph1334score, ph135score, ph136score, ph137score,
ph138score, ph139score, ph140score, ph141score).
* Match Stata rowtotal() when all components are missing.
IF (NMISS(
ph121score, ph126score, ph122score, ph123score, ph124score,
ph127score, ph128score, ph129score, ph130score, ph131score,
ph132score, ph1334score, ph135score, ph136score, ph137score,
ph138score, ph139score, ph140score, ph141score) = 19)
mmsetotal_2 = 0.
IF (hh005 > 1) mmsetotal_2 = -1.
COMPUTE mmsetotal = mmsetotal_2.
COMPUTE COGmmse = $SYSMIS.
IF (mmsetotal >= 0) COGmmse = mmsetotal.
VARIABLE LABELS COGmmse "Mini-mental state examination".
EXECUTE.