Expert: Paula Damgaard - 5/3/2004

Question
Dear Paula,

My mother's doctor tells me that my mother rates 20/30 on the Folstein-Minimental status exam. She is 92 and is suffering from some form of senile dementia. Could you tell me about this test and how significant her rating is?

We are ex South Africans living in New Zealand. My mother is in a rest home in South Africa and is very unhappy there. We are thinking of bringing her over here. I am just trying to understand her condition and to decide what is best for her.

Thank you so much.

Michael Schlumpf

Answer
Dear Michael,  the Folstein Minimental status exam, known as the MMSE, is a simple test that is administered in many doctors offices to see if there is any change with their cognition.  Normal would be 30/30 , tho some say that some can be normal at 27/30.  Once a patient drops below 26/30, that is a pretty good sign that something is going on.  

In our clinic we preform this test as a beginning of diagnosising a patient. We then would proceed to do further testing on the patient.  We usually do about 4hours worth of neuropsych testing to find out exactly what areas of the brain are working and which aren't.  This combined with the bedside neurological exam allows us to come up with a diagnosis.  There are times that we would also do an MRI scan or a CAT scan to further rule out any thing that could be causing the problem.  

My recommendation to you is to make sure that she has been properly diagnosed.  I am not sure what the medical situation is in your area or where she is but hopefully they would have access to the cholinesterase inhibitors that are on the market so it can allow her the best quality of life.  I would suggest moving her closer to you as she will need lots of care in the future and it is easier to do it when she is near you.  Good luck.  Paula