Skip to main content
American Journal of Alzheimer's Disease and Other Dementias logoLink to American Journal of Alzheimer's Disease and Other Dementias
. 2007 Oct-Nov;22(5):406–415. doi: 10.1177/1533317507304744

Can You Have Dementia With an MMSE Score of 30?

Jonah S Shiroky 1, Hyman M Schipper 2, Howard Bergman 3, Howard Chertkow 4
PMCID: PMC10846084  PMID: 17959876

Abstract

Objective. To investigate the possibility that a patient with a diagnosis oF probable Alzheimer's disease (AD) can still obtain a score oF 30/30 on the Mini-Mental State Exam (MMSE). Design. Chart review. Setting. The McGill University/Jewish General Hospital Memory Clinic. Participants. Participants were selected From the Memory Clinic's patient database. All underwent comprehensive evaluations, including relevant blood work and a computed tomographic scan or a magnetic resonance imaging scan oF the brain to rule out other causes oF dementia. Measurements. All patients had one or more neuropsychological evaluation. Data oF all psychometric testing, including the MMSE, were gathered From these visits. Results. Eight patients were Found to meet the criteria oF AD although achieving a score oF 30/30 on the MMSE. Four oF 8 patients achieved this score although they were taking cholinesterase inhibitors. Conclusion. Although rare, it is possible to achieve a score oF 30/30 on the MMSE even iF a subject is suFFering From a dementing illness.

Keywords: Mini-Mental State Examination, Alzheimer's disease, memory

Full Text

The Full Text of this article is available as a PDF (83.0 KB).

Contributor Information

Jonah S. Shiroky, Bloomfield Center For Research in Aging Montreal.

Hyman M. Schipper, Bloomfield Center For Research in Aging Montreal, Department oF Neurology and Neurosurgery, McGill University and Jewish General Hospital, Montreal, QC, Canada, Division oF Geriatric Medicine McGill University and Jewish General Hospital, Montreal, QC, Canada.

Howard Bergman, Bloomfield Center For Research in Aging Montreal, howard.chertkow@mcgill.ca., Division oF Geriatric Medicine McGill University and Jewish General Hospital, Montreal, QC, Canada.

Howard Chertkow, Bloomfield Center For Research in Aging Montreal, Department oF Neurology and Neurosurgery, McGill University and Jewish General Hospital, Montreal, QC, Canada, Division oF Geriatric Medicine McGill University and Jewish General Hospital, Montreal, QC, Canada.

References

  1. Folstein MF, Folstein SE, McHugh PR “ Mini-Mental State”: A practical method For grading the cognitive state oF patients For the clinician. J Psychiatr Res. 1975;12: 189-198. [DOI] [PubMed] [Google Scholar]
  2. Simard M. The Mini-Mental State Examination: Strengths and weaknesses oF a clinical instrument. Can Alzheimer's Dis Rev. 1998;December:10-12. [Google Scholar]
  3. Tombaugh TN, McIntyre NJ The Mini-Mental State Examination: a comprehensive review. J Am Geriatr Soc. 1992;40:922-935. [DOI] [PubMed] [Google Scholar]
  4. Gauthier S., Panisset M., Nalbantoglu J., Poirier J. Alzheimer's disease: current knowledge, management and research. CMAJ. 1997;157:1047-1052. [PMC free article] [PubMed] [Google Scholar]
  5. Doody RS, Geldmacher DS, Gordon B., Perdomo CA, Pratt RD Open-label, multicenter, phase 3 extension study oF the saFety and eFFicacy oF donepezil in patients with Alzheimer disease. Arch Neurol. 2001;58:427-433. [DOI] [PubMed] [Google Scholar]
  6. Salloway S., Ferris S., Kluger A., et al. EFFicacy oF donepezil in mild cognitive impairment: a randomized placebo-controlled trial. Neurology. 2004;63:651-657. [DOI] [PubMed] [Google Scholar]
  7. Nasreddine ZS , Phillips NA, Bedirian V., et al. The Montreal Cognitive Assessment, MoCA: a brieF screening tool For mild cognitive impairment. J Am Geriatr Soc. 2005;53:695-699. [DOI] [PubMed] [Google Scholar]
  8. Hachinski VC , IliFF LD, Zilhka E., et al. Cerebral blood Flow in dementia. Arch Neurol. 1975;32:632-637. [DOI] [PubMed] [Google Scholar]
  9. Reisberg B. Clinical assessments oF cognition in the aged. In: Shamoian CA, ed. Dementia in the Elderly. Washington, DC: American Psychiatric Association; 1984:16-35. [Google Scholar]
  10. McKann G., Drachman D., Folstein M., Katzman R., Price D., Stadlan EM Clinical diagnosis oF Alzheimer's disease: report oF the NINCDS-ADRDA work group under the auspices oF the Department oF Health Services Task Force on Alzheimer's disease. Neurology. 1984;34: 939-944. [DOI] [PubMed] [Google Scholar]
  11. Wechsler D. Wechsler Adult Intelligence Scale. New York, NY: Psychological Corporation; 1955. [Google Scholar]
  12. Wechsler D. Wechsler Memory Scale. 3rd ed. San Antonio, TX: Psychological Corporation; 1997. [Google Scholar]
  13. Schmidt M. Rey Auditory Verbal Learning Test: A Handbook. Los Angeles, CA: Western Psychological Services; 1996. [Google Scholar]
  14. Benton A., Hamsher K., Sivan AB Multilingual Aphasia Examination. Iowa City, IA: AJA Associates; 1983. [Google Scholar]
  15. Kaplan E., Goodglass H., Weintraub S. The Boston Naming Test. Philadelphia, PA: Lea & Febiger; 1983. [Google Scholar]
  16. KauFman AS, KauFman NL The Kaufman Screening Neuropsychological Assessment Procedure. Circle Pines, MN: American Guidance Service; 1994. [Google Scholar]
  17. Rouleau I., Salmon DP, Butters N., Kennedy C., McGuire K. Quantitative and qualitative analyses oF clock drawings in Alzheimer's and Huntington's disease. Brain Cogn. 1992;18:70-87. [DOI] [PubMed] [Google Scholar]
  18. Reitan RM Validity oF trail making test as an indicator oF organic brain damage. Percept Mot Skills. 1958;8:271-276. [Google Scholar]
  19. Stroop JR Studies oF interFerence in serial verbal reactions. J Exp Psychol. 1935;18:643-661. [Google Scholar]
  20. Beck AT, Ward CH, Mendelson M., Mock J., Erbaugh J. An inventory For measuring depression. Arch Gen Psychiatry . 1961;4:561-571. [DOI] [PubMed] [Google Scholar]
  21. Yesavage JA Geriatric Depression Scale. Psychopharmacol Bull. 1988;24:709-711. [PubMed] [Google Scholar]
  22. Jorm A., Scott R., Henderson A., Kay D. Educational level diFFerence on the mini-mental state: the role oF test bias . Psychol Med. 1988;18:727-731. [DOI] [PubMed] [Google Scholar]
  23. Murden RA, McRae TD, Kaner S., Bucknam ME Mini-Mental State exam scores vary with education in blacks and whites. J Am Geriatr Soc. 1991;39:149-155. [DOI] [PubMed] [Google Scholar]
  24. Espino DV, Lichtenstein MJ, Palmer RF, Hazuda HP Ethnic diFFerences in Mini-Mental State Examination (MMSE) scores: where you live makes a diFFerence. J Am Geriatr Soc. 2001;49:538-548. [DOI] [PubMed] [Google Scholar]
  25. Black SA, Espino DV, Mahurin R., et al. The inFluence oF noncognitive Factors on the Mini-Mental State Examination in older Mexican-Americans: Findings From the Hispanic EPESE. Established Population For the Epidemiologic Study oF the Elderly. J Clin Epidemiol. 1999;52:1095-1102. [DOI] [PubMed] [Google Scholar]
  26. Brayne C., Calloway P. The association oF education and socioeconomic status with the Mini Mental State Examination and the clinical diagnosis oF dementia in elderly people . Age Ageing. 1990;19:91-96. [DOI] [PubMed] [Google Scholar]
  27. Anthony JC, LeResche L., Niaz U., von KorFF MR, Folstein MF Limits oF the “Mini-Mental State” as a screening test For dementia and delirium among hospital patients. Psychol Med. 1982;12:397-408. [DOI] [PubMed] [Google Scholar]
  28. Fillenbaum GG, Hughes DC, Heyman A., George LK, Blazer DG Relationship oF health and demographic characteristics to Mini-Mental State Examination score among community residents. Psychol Med. 1988;18:719-726. [DOI] [PubMed] [Google Scholar]
  29. Galasko D., Klauber MR, HoFstetter CR, Salmon DP, Lasker B., Thal LJ The Mini-Mental State Examination in the early diagnosis oF Alzheimer's disease . Arch Neurol. 1990;47:49-52. [DOI] [PubMed] [Google Scholar]
  30. O'Connor DW , Pollitt PA, Treasure FP, Brook CP, Reiss BB The inFluence oF education, social class and sex on Mini-Mental State scores. Psychol Med. 1989;19:771-776. [DOI] [PubMed] [Google Scholar]
  31. Juby A., Tench S., Baker V. The value oF clock drawing in identiFying executive cognitive dysFunction in people with a normal Mini-Mental State Examination score. CMAJ. 2002;167:859-864. [PMC free article] [PubMed] [Google Scholar]
  32. Cobb JL, WolF PA, Au R, White R, D'Agostino RB. The effect oF education on the incidence oF dementia and Alzheimer's disease in the Framingham Study. Neurology. 1995;45:1707-1712. [DOI] [PubMed] [Google Scholar]
  33. Bleecker ML , Bolla-Wilson K., Kawas C., Agnew J. Age-speciFic norms For the Mini-Mental State Exam. Neurology. 1988;38:1565-1568. [DOI] [PubMed] [Google Scholar]
  34. Strickland TL, Longobardi PG, Alperson BL, Andre K. Mini-Mental State and Cognistat perFormance in an older AFrican American sample. Clin Neuropsychol. 2005;19:87-98. [DOI] [PubMed] [Google Scholar]
  35. Crum RM, Anthony JC, Bassett SS, Folstein MF Population-based norms For the Mini-Mental State Examination by age and educational level. JAMA. 1993; 269:2386-2391. [PubMed] [Google Scholar]
  36. Le Carret N., Auriacombe S., Letenneur L., Bergua V., Dartigues JF, Fabrigoule C. InFluence oF education on the pattern oF cognitive deterioration in AD patients: the cognitive reserve hypothesis. Brain Cogn. 2005;57:120-126. [DOI] [PubMed] [Google Scholar]
  37. Keating HJ III. “Studying” For the Mini-Mental Status Exam . J Am Geriatr Soc. 1987;35:594-595. [DOI] [PubMed] [Google Scholar]
  38. Birks J. Cholinesterase inhibitors For Alzheimer's disease. Cochrane Database Syst Rev. 2006(1):CD005593. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from American Journal of Alzheimer's Disease and Other Dementias are provided here courtesy of SAGE Publications

RESOURCES