Appendix: The Modified Mini-Mental State (3MS)

Subject ______________________yr__________ /mo______/ d_____ Examiner ____________

Normal or Dx __________ Age /yrs__________ Edu /yrs__________ M_____ F _____

3MS __________ /100

MMS __________/30

3MS

MMS

 

__
5

DATE AND PLACE OF BIRTH
Date: year ______
month_____ day _____
Place: town __________
state_______________

__
3

__
3

REGISTRATION
(No. of presentations: ______)
SHIRT, BROWN, HONESTY
(or: SOCKS, BLACK, MODESTY)
(or: SOCKS, BLUE, CHARITY)

__
7

__
5

MENTAL REVERSAL
5 to 1

Accurate

2

1 or 2 errors/misses

0

1

DLROW

0

1

2

3

4

5

__
9

__
3

FIRST RECALL

Spontaneous recall

3

After "Something to wear"

2

"SHOES, SHIRT, SOCKS"

0

1

Spontaneous recall

3

After "A color"

2

"BLUE, BLACK, BROWN"

0

1

Spontaneous recall

3

After "A good personal quality"

2

"HONESTY, CHARITY, MODESTY"

0

1

__
15

__
5

TEMPORAL ORIENTATION

Year

Accurate

8

Missed by 1 year

4

Missed by 2-5 years

0

2

Season

Accurate or within 1 month

0

1

Month

Accurate or within 5 days

2

Missed by 1 month

0

1

Day of month

Accurate

3

Missed by 1 or 2 days

2

Missed by 3-5 days

0

1

Day of week

Accurate

0

1

__
5

__
5

SPATIAL ORIENTATION

State

0

2

County

0

1

City (town)

0

1

Hospital/office building/home?

0

1

__
5

__
2

NAMING
(MMS: Pencil ___ Watch ___)
Forehead ___ Chin ____ Shoulder ____
Elbow _____ Knuckle _____

3MS

MMS

__
10

FOUR-LEGGED ANIMALS (30 seconds) 1 point ea.

__
6

SIMILARITIES

Arm-Leg

Body part; limb; etc

2

Less correct answer

0

1

Laughing-Crying

Feeling; emotion

2

Other correct answer

0

1

Eating-Sleeping

Essential for life

2

Other correct answer

0

1

__
5

__
1

REPETITION

"I WOULD LIKE TO GO HOME/OUT"

2

1 or 2 missed/wrong words

0

1

"NO IFS___ANDS___OR BUTS___"

__
3

__
1

READ AND OBEY "CLOSE YOUR EYES"

Obeys without prompting

3

Obeys after prompting

2

Reads aloud only (spontaneously or by request)

0

1

__
5

__
1

WRITING (1 minute)

(I) WOULD LIKE TO GO HOME/OUT
(MMS: Spontaneous sentence: 0 1)

__
10

__
1

COPYING TWO PENTAGONS (1 minute)

Each Pentagon

5 approximately equal sides

4

4

5 unequal (>2:1) sides

3

3

Other enclosed figure

2

2

2 or more lines

0

1

0

1

Intersection

4 corners

2

Not 4-corner enclosure

0

1

__
3

__
3

THREE-STAGE COMMAND

___ TAKE THIS PAPER WITH YOUR LEFT/RIGHT HAND

___ FOLD IT IN HALF, AND

___ HAND IT BACK TO ME

__
9

SECOND RECALL

(Something to wear)

0

1

2

3

(Color)

0

1

2

3

(Good personal quality)

0

1

2

3

 

(Teng EL, Chui HC. A Modified Mini-Mental State (3MS) Examination. Journal of Clinical Psychiatry 1987;48:314-318. Copyright Physicians Postgraduate Press. Reprinted with permission.)