Modified Mini-Mental State Test (3MS or MMMS)

Modified Mini-Mental State Test (3MS or MMMS)
Teng‚ 1987
1. WHEN AND WHERE BORN? Date dd/mm/ yyyy  Place city/province (5)
dd (1‚0)‚mm (1‚0)‚ yyyy (1‚0)‚ city/town (1‚0)‚  province (1‚0)
2. REGISTRATION (3)
THREE WORDS (Say the 3 words listed below‚ then ask the person to repeat them. Repeat until correct but only score the first attempt)
·         Shoes (1 0)
·         Blue (1 0)
·         Modesty (1 0)
3. MENTAL REVERSAL (7)
COUNTING and WORLD BACKWARDS
COUNTING FORWARDS 5 to 1 (write their answer)
·         Accurate (2)
·         1 or 2 errors / misses (0 1)
SPELL “WORLD”
“World” backwards (print letters) D L R O W (0 1 2 3 4 5)
Give one point for each correct answer
4. FIRST RECALL (9)
Ask the person to recall the 3
·         Spontaneous recall: Shoes (3)
·         Cue: Something to wear (2)
·         Multiple: Shirt‚ shoes‚ socks (1)
·         Missed completely (0)
·         Spontaneous recall: Blue (3)
·         Cue: A colour (2)
·         Multiple: Black‚ brown‚ blue (1)
·         Missed completely (0)
·          
·         Spontaneous recall: Modesty (3)
·         Cue: A good personal quality (2)
·         Multiple: Modesty‚ ch‎arity‚ honesty (1)
·         Missed completely (0)
5. TEMPORAL ORIENTATION (15)
Today’s date
·         Accurate (3)
·         Missed by 1 or 2 days (2)
·         Missed by 3–5 days (1)
·         Missed by more than 5 days (0)
Month
·         Accurate or within 5 days (2)
·         Missed by 1 month (1)
·         Missed by more than a month (0)
Year
1.    Accurate (8)
2.    Missed by 1 year (4)
3.    Missed by 2–5 years (2)
4.    Missed by more than 5 years (0)
Day of week
·         Accurate (1)
·         Missed (0)
Season
·         Accurate or within a month (1)
·         Missed (0)
6. SPATIAL ORIENTATION (5)
·         Province (2 0)
·         Country (1 0)
·         City or town (1 0)
·         Hosp.‚ store‚ home (1 0)
7. NAMING (5)
Ask the person to name the following:
·         Forehead (1 0)
·         Elbow (1 0)
·         Chin (1 0)
·         Knuckle (1 0)
·         Shoulder (1 0)
8. FOUR-LEGGED ANIMALS (10)
(30 SECONDS) 1 POINT EACH
Ask the person to name as many 4 legged animals as they can in 30 seconds. The maximum score is 10.
9. SIMILARITIES (6)
Ask the person how an Arm and Leg are similar.
Arm-leg
·         Limbs‚ extremities (2)
·         Body‚ parts‚ bend‚ move‚ joint (1)
·         Very weak similarity or no similarity (0)
Laughing-crying
·         Feeling‚ emotion (2)
·         Expressions‚ sounds‚ relieve tension (1)
·         Very weak similarity or no similarity (0)
Eating-sleeping
·         Necessary bodily functions (2)
·         Bodily functions‚ relaxing‚ good for you (1)
·         Very weak similarity or no similarity (0 )
10. REPETITION (5)
I would like to go home (out)
·         Correct (2)
·         1 or 2 missed/wrong words (1)
·         More than 2 missed/wrong words (0)
·         No ifs (1 0)
·         ands (1 0)
·         or buts (1 0)
11. READ AND OBEY “CLOSE YOUR EYES” (Use Cue Card) (3)
·         Obeys without prompting 3
·         Obeys after prompting (2)
·         Read aloud only (1)
·         None of the above (0)
12. WRITING (5)
(1 minute)
Ask the person to write on the next page: (I) would like to go home (out) (0 1 2 3 4 5)
13. COPYING TWO PENTAGONS (1 minute) (10)
Ask the person to copy the design on the next page.
·         5 approx equal sides: Pentagon 1(4)‚ Pentagon 2 (4)
·         5 unequal (2:1) sides: Pentagon 1(3)‚ Pentagon 2 (3)
·         Other enclosed figures: Pentagon 1(2)‚ Pentagon 2 (2)
·         2 or more lines: Pentagon 1(1)‚ Pentagon 2 (1)
·         Less than 2 lines: Pentagon 1(0)‚ Pentagon 2 (0)
Intersection
·         4 corners (2)
·         Not 4 corner enclosure (1)
·         No intersection or no enclosure (0)
14. THREE STAGE COMMAND (3)
Ask the person to follow a 3 stage command: ‘Take a piece of paper in your left/right hand‚ fold it in half‚ and hand it back to me’.
·         Take this paper with your . . .
·         Left/right hand (1 0)
·         fold it in half (1 0)
·         and hand it back to me (1 0)
15. SECOND RECALL (9)
Ask the person to recall the 3 words from 4th question.
·         Spontaneous recall: Shoes (3)
·         Cue: Something to wear (2)
·         Multiple: Shirt‚ shoes‚ socks (1)
·         Missed completely (0)
·         Spontaneous recall: Blue (3)
·         Cue: A colour (2)
·         Multiple: Black‚ brown‚ blue (1)
·         Missed completely (0)
·          
·         Spontaneous recall: Modesty (3)
·         Cue: A good personal quality (2)
·         Multiple: Modesty‚ ch‎arity‚ honesty (1)
·         Missed completely (0)

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McDowell‚ I.‚ Kristjansson‚ B.‚ Hill‚ G.B.‚ et al. (1997). Community screening for dementia: the Mini-Mental State Exam (MMSE) and Modified Mini-Mental State Exam (3MS) compared. J Clin Epidemiol‚ 50:377–383.

Correa‚ J.A.‚ Perrault‚ A.‚ Wolfson‚ C. (2000). Reliable individual change scores on the 3MS in older persons with dementia: results from the Canadian Study of Health and Aging. Int Psychogeriatr‚ 12(suppl. 2):73–80.

Tschanz‚ J.T.‚ Welsh-Bohmer‚ K.A.‚ Plassman‚ B.L‚ et al. (2002). An adaptation of the Modified Mini-Mental State Examination: analysis of demographic influences and normative data. Neuropsychiatry Neuropsychol Behav Neurol;15:28–38.

McDowell‚ Ian. (2006). Measuring Health: A Guide to Rating Scales and Questionnaires‚ Third Edition. OXFORD UNIVERSITY PRESS