7 ms·

“Mini-mental state” (1974) [pdf]

40 points by memorable 4y ago

mherdeg 4y ago
I've read "apple table penny" so often that I hope I remember to ask my evaluator to use a different three words when the time comes.
baxtr 4y ago
From the paper: > “MINI-MENTAL STATE” A PRACTICAL METHOD FOR GRADING THE COGNITIVE STATE OF PATIENTS FOR THE CLINICIAN (..) the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely. It is “mini” because it concentrates only on the cognitive aspects of mental functions, and excludes questions concerning mood, abnormal mental experiences and the form of thinking. But within the cognitive realm it is thorough.
mc680x0 4y ago
The MMSE is still a useful clinical tool today, simple enough to be administered with nothing more than a pen and a few scraps of paper. That said, it's certainly better if your exam subjects are suffering from dementia, so they can't memorise the answers ;-)
- cm42 4y ago
  It's a good first-pass for other types of neurological impairment, too - head injuries, strokes, etc. Despite this paper (and most forms) clearly specifying "three objects", I've always seen this taught as three random/arbitrary words of different "types" - adjective/noun/verb, person/place/thing - or just "two common objects" instead of exactly a pen and a watch. It's always fascinating to me when patients come up with incorrect-but-clever words for common items: "cutters" for scissors, "timeclock" for watch, "cigarette starter" for a lighter, etc.
MrVandemar 4y ago
I've seen a few of these and I know I I'll struggle to spell "World" backwards, even at the height of my cognitive ability. Better start practicing today so I can get it right in my dotage :)
- matheusmoreira 4y ago
  You can do the calculations if you'd like. This test's true importance is the fact it distracts the patient after registration so that recall is properly tested.
greggarious 4y ago
Most of these things are pre internet, and don't account for the fact the patient may have read up on the diagnostic instrument. I used to literally sit reading the DSM and associated inventories during in school suspensions, if you do not have a chemical imblanace, most of psychiatry is bullshit, and folks should self medicate with cannabis and low caffeine drinks like black tea rather than risk the permanent cognitive harm and withdrawal symptoms of SSRIs often prescribed to bring your behavior into compliance when you are reacting to the antisocial actions of others. (Therapy, OTOH is useful, but therapy needs to define goals and and exit strategy, or it can turn extortionary -- paying someone to certify your sanity as they siphon up your deepest fears and desires... and then obstructs them through inaction, since if you're on HN, you're going to be as smart or smarter than the therapist.)
- swamp40 4y ago
  > if you do not have a chemical imblanace > folks should self medicate with cannabis and low caffeine drinks like black tea I am a huge proponent of SSRIs. I have seen them work wonders. And I haven't seen any "permanent cognitive harm". Cannabis, on the other hand: Also a drug. Most definitely can cause behavioral changes. I'm not against it, but don't be naïve.
  - greggarious 4y ago
    That presumes you have depression. If you do, I am as well. In grad school, my university counseling center tried several (some of which had been tried in childhood), and then diagnosed me with CPTSD and GAD from the treatment I endured in K12, handed me an alaprazolam script, and encouraged me to try to live a fulfilling life on top of being on the autistic spectrum. OTOH I found cannabis helps when other things didn't, but there were supply chain issues since I was rapidly shifting from nearly joining the NSA to, by my mid 20s, authoring the beginnings of a PhD thesis on how we could better design anonymnity tools for non-computer scientists, which I recently posted in new but don't want to spam. The issue is that we pretend there is one treatment for all sadnesses, when often sadness is reactive. Combine that with the fact folks often want to do drugs to feel good, and that IMHO adds value to cannabis -- it's less addictive than alaprazolam or SSRIs and can be stopped more rapidly with less dangerous side effects. (Feel free to drop contact details if you want to discuss this further, today is the last Friday I will be posting about anything but tech on HN, but it's hard to do that: the personal computer is political.)
swamp40 4y ago
Serial sevens (or, more generally, the descending subtraction task; DST), where a patient counts down from one hundred by sevens, is a clinical test used to test cognition. ~ Wikipedia
- swamp40 4y ago
  They stopped using it to diagnose sports concussions because "the pass rate is too low to give any meaningful result".

40 points by memorable 4y ago

I've read "apple table penny" so often that I hope I remember to ask my evaluator to use a different three words when the time comes.

baxtr 4y ago

From the paper: > “MINI-MENTAL STATE” A PRACTICAL METHOD FOR GRADING THE COGNITIVE STATE OF PATIENTS FOR THE CLINICIAN (..) the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely. It is “mini” because it concentrates only on the cognitive aspects of mental functions, and excludes questions concerning mood, abnormal mental experiences and the form of thinking. But within the cognitive realm it is thorough.

mc680x0 4y ago

The MMSE is still a useful clinical tool today, simple enough to be administered with nothing more than a pen and a few scraps of paper. That said, it's certainly better if your exam subjects are suffering from dementia, so they can't memorise the answers ;-)

cm42 4y ago
It's a good first-pass for other types of neurological impairment, too - head injuries, strokes, etc. Despite this paper (and most forms) clearly specifying "three objects", I've always seen this taught as three random/arbitrary words of different "types" - adjective/noun/verb, person/place/thing - or just "two common objects" instead of exactly a pen and a watch. It's always fascinating to me when patients come up with incorrect-but-clever words for common items: "cutters" for scissors, "timeclock" for watch, "cigarette starter" for a lighter, etc.

MrVandemar 4y ago

I've seen a few of these and I know I I'll struggle to spell "World" backwards, even at the height of my cognitive ability. Better start practicing today so I can get it right in my dotage :)

matheusmoreira 4y ago
You can do the calculations if you'd like. This test's true importance is the fact it distracts the patient after registration so that recall is properly tested.

greggarious 4y ago

Most of these things are pre internet, and don't account for the fact the patient may have read up on the diagnostic instrument. I used to literally sit reading the DSM and associated inventories during in school suspensions, if you do not have a chemical imblanace, most of psychiatry is bullshit, and folks should self medicate with cannabis and low caffeine drinks like black tea rather than risk the permanent cognitive harm and withdrawal symptoms of SSRIs often prescribed to bring your behavior into compliance when you are reacting to the antisocial actions of others. (Therapy, OTOH is useful, but therapy needs to define goals and and exit strategy, or it can turn extortionary -- paying someone to certify your sanity as they siphon up your deepest fears and desires... and then obstructs them through inaction, since if you're on HN, you're going to be as smart or smarter than the therapist.)

swamp40 4y ago
> if you do not have a chemical imblanace > folks should self medicate with cannabis and low caffeine drinks like black tea I am a huge proponent of SSRIs. I have seen them work wonders. And I haven't seen any "permanent cognitive harm". Cannabis, on the other hand: Also a drug. Most definitely can cause behavioral changes. I'm not against it, but don't be naïve.
- greggarious 4y ago
  That presumes you have depression. If you do, I am as well. In grad school, my university counseling center tried several (some of which had been tried in childhood), and then diagnosed me with CPTSD and GAD from the treatment I endured in K12, handed me an alaprazolam script, and encouraged me to try to live a fulfilling life on top of being on the autistic spectrum. OTOH I found cannabis helps when other things didn't, but there were supply chain issues since I was rapidly shifting from nearly joining the NSA to, by my mid 20s, authoring the beginnings of a PhD thesis on how we could better design anonymnity tools for non-computer scientists, which I recently posted in new but don't want to spam. The issue is that we pretend there is one treatment for all sadnesses, when often sadness is reactive. Combine that with the fact folks often want to do drugs to feel good, and that IMHO adds value to cannabis -- it's less addictive than alaprazolam or SSRIs and can be stopped more rapidly with less dangerous side effects. (Feel free to drop contact details if you want to discuss this further, today is the last Friday I will be posting about anything but tech on HN, but it's hard to do that: the personal computer is political.)

swamp40 4y ago

Serial sevens (or, more generally, the descending subtraction task; DST), where a patient counts down from one hundred by sevens, is a clinical test used to test cognition. ~ Wikipedia

swamp40 4y ago
They stopped using it to diagnose sports concussions because "the pass rate is too low to give any meaningful result".