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Mini Mental State Examination (MMSE)

The Mini International Neuropsychiatric Interview (MINI) (section: mental health) was measured in all elderly Lifelines participants during:


The Mini Mental State Examination (MMSE) is a brief cognition test used to assess cognitive impairments (section: mental health). It is commonly used in medicine and allied health to screen for dementia.
The MMSE was performed in ca. 12.000 elderly (65+) participants during 1A Visit 1. ~12% scored below 24 points (NB: in case of an MMSE score <26 at 1A visit 1, the Proxy interview was performed on location).
The MMSE is implemented again in 3A Visit 1
The MMSE is used in conjunction with other cognition tests in Lifelines, i.e. the RFFT (also during 1A Visit 1 and 3A Visit 1) and the CogState (during 2A visit 1 and 3A Visit 1), and with several cognition-related questions. The MMSE should not be confused with the Mini Neuropsychiatric Interview, which is also used in Lifelines but assesses anxiety and depression.

De MMSE includes simple questions and tasks in a number of areas:

  • orientation (V1a-e, V2a-e, max. 10 points);
  • registration (V3, max. 3 points);
  • attention and calculation (V4, max. 5 points);
  • recall (V5, max. 3 points);
  • language (V6-10, max. 8 points);
  • basic motor skills (V11, max. 1 point, copy a drawing of two pentagons as shown in figure).


A total of 30 points can be scored in the MMSE (see English protocol for details on scoring). The final score will give a first indication of the presence and level of cognitive impairment (but note that the MMSE is not a diagnostic instrument).

  • 24-30 points: No cognitive impairment
  • 18-23 points: Mild to moderate cognitive impairment
  • 0-17 points: Severe cognitive impairment

Note that in Lifelines, the computer programme gave the following raw data scores:

  • 12 out of 30 items were scored as 1 for correct and 0 for incorrect
  • 18 out of 30 items were scored as 2 for correct and 1 for incorrect

The programme therefore subtracted 1 from each score in these 18 items to get the final score.
When raw MMSE data are used for calculations, the same subtraction should be made.
The Lifelines protocol of the MMSE (in Dutch) can be downloaded here: mmse_in_dutch.pdf
The English equivalent can be downloaded here: mmse_in_english.pdf


English Dutch Code Variable Assessment Age
What year is it? (Correct?) Welk jaar is het? (Correct?) mmse_time_adu_m_01_a V1A 1A 3A 65+
What season is it? (Correct?) Welk seizoen is het? (Correct?) mmse_time_adu_m_01_b V1B 1A 3A 65+
Which month of the year is it? (Correct?) Welke maand van het jaar is het? (Correct?) mmse_time_adu_m_01_c V1C 1A 3A 65+
What is today's date? (Correct?) Wat is de datum van vandaag? (Correct?) mmse_time_adu_m_01_d V1D 1A 3A 65+
What day of the week is it today? (Correct?) Welke dag van de week is het? (Correct) mmse_time_adu_m_01_e V1E 1A 3A 65+
In which province are we now? (Correct?) In welke provincie zijn we nu? (Correct?) mmse_place_adu_m_02_a V2A 1A 3A 65+
In what city or town are we now? (Correct?) In welke plaats zijn we nu? (Correct?) mmse_place_adu_m_02_b V2B 1A 3A 65+
In what street are we now? (Correct?) In welke straat zijn we nu? (Correct?) mmse_place_adu_m_02_c V2C 1A 3A 65+
What is this building called? (Correct?) Hoe heet dit gebouw? (Correct?) mmse_place_adu_m_02_d V2D 1A 3A 65+
On what floor are we now? (Correct?) Op welke verdieping zijn we nu? (Correct?) mmse_place_adu_m_02_e V2E 1A 3A 65+
I will name three objects now. Could you repeat them after I've said all three? Apple. (Correct?) Ik noem nu drie voorwerpen. Wilt u die herhalen nadat ik ze alle drie gezegd heb? Appel. (Correct?) mmse_object_adu_m_03_a V3A 1A 3A 65+
Key. (Correct?) Sleutel. (Correct?) mmse_object_adu_m_03_b V3B 1A 3A 65+
Table. (Correct?) Tafel. (Correct?) mmse_object_adu_m_03_c V3C 1A 3A 65+
Could you subtract seven from 100 and subtract seven again from that number and keep going like that? (score: 0-5 points) Wilt u van de 100 zeven aftrekken en van wat overblijft weer zeven aftrekken en zo doorgaan? (score: 0-5 punten) mmse_calculation_adu_m_04 V4 1A 3A 65+
Could you mention again the three objects I just named? Apple. (Correct?) Noemt u nogmaals de drie voorwerpen van zojuist. Appel. (Correct?) mmse_recall_adu_m_05_a V5A 1A 3A 65+
Key. (Correct?) Sleutel. (Correct?) mmse_recall_adu_m_05_b V5B 1A 3A 65+
Table. (Correct?) Tafel. (Correct?) mmse_recall_adu_m_05_c V5C 1A 3A 65+
What is this? Pen. (Correct?) Wat is dit? Pen. (Correct?) mmse_object_adu_m_06_a V6A 1A 3A 65+
And what is that? Watch. (Correct?) En wat is dat? Horloge. (Correct?) mmse_object_adu_m_06_b V6B 1A 3A 65+
Could you repeat the following sentence: Now this, and then that again. (Correct?) Wilt u de volgende zin herhalen: Nu eens dit en dan weer dat. (Correct?) mmse_language_adu_m_07 V7 1A 3A 65+
Could you please read these words and then do what they say? (Paper on which is written in large letters: Close your eyes.) (Correct?) Wilt u deze woorden lezen en dan doen wat er staat?(Papier met daarop in grote letters: Sluit uw ogen.) (Correct?) mmse_language_adu_m_08 V8 1A 3A 65+
Could you pick up this paper with your right hand, fold it in two and then put it on your lap? (Right hand, correct?) Wilt u dit papiertje pakken met uw rechterhand, het dubbelvouwen en het op uw schoot leggen? (Rechter hand, correct?) mmse_motor_adu_m_09_a V9A 1A 3A 65+
Is the paper folded? Is het papiertje dubbelgevouwen? mmse_motor_adu_m_09_b V9B 1A 3A 65+
Was the paper placed on the lap? Is het papiertje op de schoot gelegd? mmse_motor_adu_m_09_c V9C 1A 3A 65+
Could you write a complete sentence on this piece of paper? (Correct?) Wilt u voor mij een volledige zin opschrijven op dit stuk papier? (Correct?) mmse_write_adu_m_10 V10 1A 3A 65+
Could you copy this figure? (Correct?) Wilt u deze figuur natekenen? (Correct?) mmse_draw_adu_m_11 V11 1A 3A 65+
MMSE total score MMSE totaal score mmse_score_adu_m_01 SCORE 1A 3A 65+
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mini_mental_state_examination.txt · Last modified: 2021/02/04 12:28 by trynke