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Family Medicine

Answer 3
  1. The MMSE has both written and verbal responses. Quantitative mental status examination is essential to the work-up of memory loss complaints. The Folstein MMSE has become the gold standard screening test and takes less than 10 minutes to administer in the office. Generally, scores less than 21 (maximum points, 30) indicate cognitive impairment, but the score alone is never diagnostic and the patient’s educational level must be taken into account. The test cannot differentiate between the different types of dementia nor can it differentiate pseudodementia (major depression masquerading as cognitive impairment) from true dementia. Testing requires verbal responses and reading, writing, and mathematical ability as well as vision and motor control skills.3

    3. Costa PT Jr, Williams TF, Somerfield M, et al. Early identification of Alzheimer’s disease and related dementias. Clinical practice guideline, quick reference guide for clinicians, No. 19. Rockville (MD): U.S. Department of Health and Human Services; 1996.

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