Mini-Mental State: A Practical Method for Grading the Cognitive State of Patients for the Clinician
1975 · paper · Biomedicine
Introduces the Mini-Mental State, an eleven-question, 30-point cognitive examination taking 5–10 minutes. The authors report documenting its validity and reliability in 206 patients with dementia, affective disorder and other conditions, and in 63 normal subjects.
2 findings
Substance Results: "the mean score for patients with dementia was 9·7", but Table 1A (Sample A, on admission, N = 29) prints a dementia mean of 9.6.
- p. 4 Results, Validity, first paragraph
dementia was 9·7
- p. 3 Table 1A, Dementia row, MMS mean
9.6
- p. 4 Results, Validity, first paragraph
the mean score for patients with dementia was 9·7
Only the authors can say what is right here.
Judge's note: Page 4 text shows 9·7. The page 3 Table 1A image shows 9.6. The other three means in the same sentence (19.0, 25.1, 27.6) match Table 1A exactly. The other dementia subsets (6.9, 10.5, 12.2) do not explain 9.7. Only the authors can say which value is correct.
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Wording Summary says Sample B low scores occurred 'essentially only in patients with dementia, delerium, schizophrenia or affective disorder', but Sample B has no delirium group and the Results say 'Scores below 20 were found only in functional psychosis or dementia'.
- p. 8 Summary
dementia, delerium, schizophrenia or affective disorder
- p. 6 Results, Sample B paragraph
Scores below 20 were found only in functional psychosis or dementia
- p. 8 Summary
dementia, delerium, schizophrenia
Only the authors can say what is right here.
Judge's note: Sample B diagnoses in the Methods and Table 2 (page 3 image) are dementia, depression, mania, schizophrenia, personality disorder with drug abuse, and neurosis. There is no delirium group. The Results on page 6 do not mention delirium. Delirium appears only as the single illustrative case in Fig. 2 and in the Introduction. No statement folds delirium into dementia, so the Summary misdescribes the data.
Second check: another model agreed
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13 minor (typos and the like; most checked by the judge only)
Wording Introduction lists the diagnoses of the 206 patients as "dementia syndromes, affective disorder, affective disorder with cognitive impairment ... mania, schizophrenia, personality disorders, and in 63 normal subjects", which leaves out the 27 neurosis patients counted in Sample B.
- p. 1 Introduction, third paragraph
mania, schizophrenia, personality disorders, and in 63 normal subjects
- p. 2 Methods, Sample B
and 27 with neurosis
Judge's note: Page 1 image: the list has no neurosis. Page 2 Methods and Table 2 (page 3) include 27 patients with neurosis among the 137 in Sample B. 69 + 137 = 206, so the 206 includes them. The paper defines neurosis separately from personality disorder (page 4), so neurosis is not covered by 'personality disorders'.
Second check: another model agreed
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Wording Table 1A prints Mann-Whitney U = "65.8" for the depression-with-cognitive-impairment row. Under the declared test (Mann-Whitney U, which takes integer or half-integer values), this value and the declared statistic do not correspond.
- p. 3 Table 1A, Depression with cognitive impairment row, Mann-Whitney U
65.8
Only the authors can say what is right here.
Judge's note: The crop and page 3 image clearly show 65.8. Rank sums with mid-ranks are multiples of 0.5, so U = R1 - n1(n1+1)/2 can only be a multiple of 0.5. The other U values in the table (45, 1178, 4, 8.5) all fit this. The paper describes no other form of the statistic. Only the authors can say what the value should be.
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Wording Text: "the product moment correlation for test 1 vs test 2 was 0·98", but Table 4 prints Pearson r = 0.988 for the 28-day retest (0.99 at two decimals).
- p. 6 Reliability, last paragraph
test 1 vs test 2 was 0·98
- p. 4 Table 4, 28 day retest row, Pearson r
0.988
- p. 6 Results, Reliability, last paragraph
the product moment correlation for test 1 vs test 2 was 0·98
Judge's note: Page 6 text and page 4 Table 4 image. The 24-hour values are quoted to three decimals and match the table (0.887, 0.827). The 28-day value is truncated rather than rounded.
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Wording The text describes the 28-day retest group as "elderly depressed and demented patients chosen for their clinical stability", but Table 4 gives its composition as "dementia, depression, schizophrenia".
- p. 6 Reliability, last paragraph
When elderly depressed and demented patients chosen for their clinical stability
- p. 4 Table 4, 28 day retest, Sample Composition
dementia, depression, schizophrenia
- p. 6 Reliability
elderly depressed and demented patients chosen for their clinical stability
Judge's note: Page 6 text and page 4 Table 4 image. Only one 28-day sample exists (N = 23), and the text leaves out schizophrenia.
Second check: another model agreed
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Wording The Results say "Scores below 20 were found only in functional psychosis or dementia", but the Summary says "the score of 20 or less was found essentially only in patients with dementia, delerium, schizophrenia or affective disorder". The two threshold statements differ (<20 vs ≤20).
- p. 6 Results, Sample B paragraph
Scores below 20 were found only in functional psychosis or dementia
- p. 8 Summary
the score of 20 or less was found essentially only in patients with dementia
- p. 8 Summary
the score of 20
- p. 6 Results, Sample B
Scores below 20 were found only in functional
Only the authors can say what is right here.
Judge's note: Page 6 and page 8 images. The same Sample B finding is given with different cut-offs. The Results give no direct support for where scores of exactly 20 fell.
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Typo Misspelling "clinically recognizeable cognitive impairment" (should be 'recognizable').
- p. 2 Methods, Sample A
clinically recognizeable cognitive impairment
- p. 2 Methods, Sample A
clinically recognizeable
Judge's note: The page 2 image shows 'recognizeable' in the Sample A description.
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Typo The instrument, titled and defined as the "Mini-Mental State" (MMS), is called "Mini-Mental Status" in the Results (e.g., "Mean initial Mini-Mental Status score", "For Mini-Mental Status vs Verbal IQ") and the Summary ("The Mini-Mental Status was useful").
- p. 4 Results, Validity
Mean initial Mini-Mental Status score
- p. 6 Results, concurrent validity and Reliability
For Mini-Mental Status vs Verbal IQ
- p. 8 Summary
The Mini-Mental Status was useful
Judge's note: Seen in the page 1 title and Introduction, page 4, page 6 (several times) and the page 8 Summary. This is a naming inconsistency only; the meaning is clear.
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Typo 'delirium' is misspelled "delerium" in the Results ("a metabolic delerium"), the Fig. 2 caption, the end of the Discussion ("dementia and delerium") and the Summary ("delerium, schizophrenia").
- p. 5 Results text and Fig. 2 caption
recovering from a metabolic delerium
- p. 8 Discussion end and Summary
such as dementia and delerium
- p. 5 Results and Fig. 2 caption
metabolic delerium
- p. 8 Discussion end and Summary
dementia and delerium
Judge's note: Seen in the page 5 and page 8 images. The Introduction (page 1) spells it 'delirium'.
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Typo "MMS in a consecutive series of admission" should read 'admissions'.
- p. 6 Results, first line after Fig. 3
MMS in a consecutive series of admission
Judge's note: Page 6 image. The next sentence says 'consecutive admissions'.
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Typo Comma splice: "Thus the scores seem stable even when multiple examiners are used, the practice effect is small."
- p. 6 Reliability
multiple examiners are used, the practice effect is small
Judge's note: Page 6 image. Two independent clauses are joined by a comma only. This is cosmetic.
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Typo Discussion sentence does not parse: 'It also though because special attention is focused on memory and language functions will reveal the partial cognitive disabilities...'
- p. 7 Discussion, last paragraph
It also though because special attention is focused on memory and language functions will reveal
Only the authors can say what is right here.
Judge's note: The page 7 image (last line), continuing onto page 8, prints exactly this wording. A word appears to be missing or wrong (perhaps 'though brief' or 'thorough'). The intended wording is not certain, so it goes to the authors.
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Typo Possessive apostrophe missing: 'in terms of a patients capacity to care for himself' should read 'a patient's capacity'.
- p. 7 Discussion
in terms of a patients capacity to care for himself
- p. 7 Discussion, fifth paragraph
terms of a patients capacity to care for himself
Judge's note: The page 7 image (Discussion, fifth paragraph) shows 'a patients capacity'. The next sentence on the same page correctly uses 'the patient's competency'.
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Typo Misspelling 'dementia and delerium' (should be 'delirium'). The same spelling appears in the Summary and the Fig. 2 caption.
- p. 8
dementia and delerium
Judge's note: The page 8 image shows 'delerium' at the end of the Discussion and in the Summary. The text layer also gives 'metabolic delerium' in the Fig. 2 caption, while the Introduction spells it 'delirium'.
Second check: none (judge only)