Skip to main content

Modified Mini-Mental State Examination

  • Living reference work entry
  • First Online:
Encyclopedia of Clinical Neuropsychology

Synonyms

3MS

Description

The Modified Mini-Mental State Examination (3MS) was developed by Teng and Chui (1987) and is an expanded version of the Mini-Mental Status Exam (MMSE) designed to increase the MMSE’s sensitivity. The 3MS incorporates four added test items, more graded scoring, and some other minor changes. These modifications are designed to sample a broader variety of cognitive functions, cover a wider range of difficulty levels, and enhance the reliability and the validity of the MMSE (Spencer et al. 2013). The four additional questions added to the original MMSE assess temporal and spatial orientation, the ability to see relations between objects, verbal fluency, and memory (i.e., date and place of birth, word fluency, similarities, and delayed recall of words). The 3MS also includes items that assess different aspects of memory, including cued recall, recognition memory, delayed free and cued recall, and delayed recognition memory. An advantage of the 3MS is that both a...

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References and Reading

  • Abraham, I. L., Manning, C. A., Boyd, M. R., Neese, J. B., Newman, M. C., Plowfield, L. A., & Reel, S. J. (1993). Cognitive screening of nursing home residents: Factor analytic structure of the Modified Mini-Mental State (3MS) Examination. International Journal of Geriatric Psychiatry, 8, 133–138.

    Article  Google Scholar 

  • Andrew, M. K., & Rockwood, K. (2008). A five-point change in Modified Mini-Mental State Examination was clinically meaningful in community-dwelling elderly people. Journal of Clinical Epidemiology, 61(8), 827–831.

    Article  PubMed  Google Scholar 

  • Barrett, J. J., Haley, W. E., & Powers, R. E. (1996). Alzheimer’s disease patients and their caregivers: Medical care issues for the primary care physician. Southern Medical Journal, 89(1), 1–9.

    Article  PubMed  Google Scholar 

  • Bassuk, S. S., & Murphy, J. M. (2003). Characteristics of the Modified Mini-Mental State Exam among elderly persons. Journal of Clinical Epidemiology, 56, 622–628.

    Article  PubMed  Google Scholar 

  • Besson, P. S., & Labbe, E. E. (1997). Use of the Modified Mini-Mental State Examination with children. Journal of Child Neurology, 12(7), 455–460.

    Article  PubMed  Google Scholar 

  • Bravo, G., & Hébert, R. (1997a). Age-and education-specific references values for the Mini-Mental and Modified Mini-Mental State Examinations derived from a non-demented elderly population. International Journal of Geriatric Psychiatry, 12(10), 1008–1018.

    Article  PubMed  Google Scholar 

  • Bravo, G., & Hébert, R. (1997b). Reliability of the modified Mini-Mental State Examination in the context of a two-phase community prevalence study. Neuroepidemiology, 16(3), 141–148.

    Article  PubMed  Google Scholar 

  • Brown, L. M., Schinka, J. A., Mortimer, J. A., & Graves, A. B. (2003). 3MS normative data for elderly African Americans. Journal of Clinical and Experimental Neuropsychology, 25(2), 234–241.

    Article  PubMed  Google Scholar 

  • Canadian Study of Health and Aging Working Group. (1994). Canadian study of health and aging: Study methods and prevalence of dementia. Canadian Medical Association Journal, 6, 433–440.

    Google Scholar 

  • Correa, J. A., Perrault, H., & Wolfson, C. (2001). Reliable individual change scores on the 3MS in older persons with dementia: Results from the Canadian study of health and aging. International Psychogeriatrics, 13(Suppl. 1), 71–78.

    Article  PubMed  Google Scholar 

  • Crum, R. M., Anthony, J. C., Bassett, S. S., & Folstein, M. F. (1993). Population-based norms for the Mini-Mental State Examination by age and educational level. Journal of the American Medical Association, 269(18), 2386–2391.

    Article  PubMed  Google Scholar 

  • Cullen, B., O'Neill, B., Evans, J. J., Coen, R. F., & Lawlor, B. A. (2007). A review of screening tests for cognitive impairment. Journal of Neurology, Neurosurgery & Psychiatry, 78(8), 790–799.

    Article  Google Scholar 

  • Fillenbaum, G. G., Hughes, D. C., Heyman, A., George, L. K., & Blazer, D. G. (1988). Relationship of health and demographic characteristics to Mini-Mental State Examination scores among community residents. Psychological Medicine, 18(3), 719–726.

    Article  PubMed  Google Scholar 

  • Grace, J., Nadler, J. D., White, D. A., Guilmette, T. J., Giuliano, A. J., Monsch, A. U., & Snow, M. G. (1995). Folstein vs. Modified Mini-Mental State Examination in geriatric stroke: Stability, validity, and screening utility. Archives of Neurology, 52(5), 477–484.

    Article  PubMed  Google Scholar 

  • Hébert, R., Bravo, G., & Girouard, D. (1992). Validation de l'adaptation française du Modified Mini-Mental State (3MS). Rev Gériatrie, 17, 443–450.

    Google Scholar 

  • Henon, H., Durieu, I., Guerouaou, D., Lebert, F., Pasquier, F., & Leys, D. (2001). Poststroke dementia: Incidence and relationship to prestroke cognitive decline. Neurology, 57(7), 1216–1222.

    Article  PubMed  Google Scholar 

  • Iliffe, S., Wilcock, J., Austin, T., Walters, K., Rait, G., Turner, S., … & Downs, M. (2002). Dementia diagnosis and management in primary care: Developing and testing educational models. Dementia, 1, 10–23.

    Google Scholar 

  • Jones, T. G., Schinka, J. A., Vanderploeg, R. D., Small, B. J., Graves, A. B., & Mortimer, J. A. (2002). 3MS normative data for the elderly. Archives of Clinical Neuropsychology, 17(2), 171–177.

    Article  PubMed  Google Scholar 

  • Jorm, A. F., Scott, R., Henderson, A. S., & Kay, D. W. (1988). Educational level differences on the Mini-Mental State: The role of test bias. Psychological Medicine, 18(3), 727–788.

    Article  PubMed  Google Scholar 

  • Lamarre, C. J., & Patten, S. B. (1991). Evaluation of the Modified Mini-Mental State Examination in a general psychiatric population. Canadian Journal of Psychiatry, 36(7), 507–511.

    Article  PubMed  Google Scholar 

  • McDowell, I., Kristjansson, B., Hill, G. B., & Hebert, R. J. (1997). Community screening for dementia: The Mini Mental State Exam (MMSE) and Modified Mini-Mental State Exam (3MS) compared. Journal of Clinical Epidemiology, 50(4), 377–383.

    Article  PubMed  Google Scholar 

  • Meiran, N., Stuss, D. T., Guzman, A., Lafleche, G., & Willmer, J. (1996). Diagnosis of dementia: Methods for interpretation of scores of 5 neuropsychological tests. Archives of Neurology, 53(10), 1043–1054.

    Article  PubMed  Google Scholar 

  • Nadler, J. D., Relkin, N. R., Cohen, M. S., Hodder, R. A., Reingold, J., & Plum, F. (1995). Mental status testing in the elderly nursing home populations. Journal of Geriatric Neurology, 8(3), 177–183.

    Article  Google Scholar 

  • O'Connell, M. E., Tuokko, H., Graves, R. E., & Kadlec, H. (2004). Correcting the 3MS for bias does not improve accuracy when screening for cognitive impairment or dementia. Journal of Clinical and Experimental Neuropsychology, 26(7), 970–980.

    Article  PubMed  Google Scholar 

  • O'Keeffe, S. T., Mulkerrin, E. C., Nayeem, K., Varughese, M., & Pillay, I. (2005). Use of serial Mini-Mental State Examinations to diagnose and monitor delirium in elderly hospital patients. Journal of American Geriatric Society, 53(5), 867–870.

    Article  Google Scholar 

  • Ouvrier, R. A., Goldsmith, R. F., Ouvrier, S., & Williams, I. C. (1993). The value of the Mini-Mental State Examination in childhood: A preliminary study. Journal of Child Neurology, 8(2), 145–149.

    Article  PubMed  Google Scholar 

  • Shadlen, M.-F., Siscovick, D., Fitzpatrick, A. L., Dulberg, C., Kuller, L. H., & Jackson, S. (2006). Education, cognitive test scores, and black-white differences in dementia risk. Journal of the American Geriatrics Society, 54(6), 898–905.

    Article  PubMed  Google Scholar 

  • Sheheta, G. A., Abdel-Kareem, M. I., Yassin, A. N., & El Adl, A. H. R. (2010). Subclinical cerebrovascular cognitive function and mood changes in patients with systemic lupus erythematosus. Rheumatology: Research and Reviews, 2, 17–25.

    Google Scholar 

  • Sink, K. M., Craft, S., Smith, S. C., Maldjian, J. A., Bowden, D. W., Xu, J., … & Divers, J. (2015). Montreal cognitive assessment and modified mini mental state examination in African Americans. Journal of Aging Research, 2015, 1–6.

    Google Scholar 

  • Spencer, R. J., Wendell, C. R., & Giggey, P. P. (2013). Psychometric limitations of the mini-mental state examination among nondemented older adults: An evaluation of neurocognitive and magnetic resonance imaging correlates. Experimental Aging Research, 39, 382–397.

    Article  PubMed  Google Scholar 

  • St. John, P. D., Tyas, S. L., & Montgomery, P. R. (2015). Cognition, even in the normal range, predicts disability: Cross-sectional and prospective analyses of a population-based sample. International Journal of Geriatric Psychiatry, 30(10), 1008–1016.

    Article  PubMed  Google Scholar 

  • Strauss, E., Sherman, E. M. S., & Spreen, O. (2006). A compendium of neuropsychological tests: Administration, norms and commentary (3rd ed.). New York: Oxford University Press.

    Google Scholar 

  • Teng, E. L., & Chui, H. C. (1987). The Modified Mini-Mental State (3MS) Examination. Journal of Clinical Psychiatry, 48(8), 314–318.

    PubMed  Google Scholar 

  • Teng, E. L., Chui, H. C., Schneider, L. S., & Metzger, L. E. (1987). Alzheimer’s dementia: Performance on the Mini-Mental State Examination. Journal of Consulting and Clinical Psychology, 55(1), 96–100.

    Article  PubMed  Google Scholar 

  • Tombaugh, T. N. (2005). How much change in the MMSE and 3MS is a significant change? Archives of Clinical Neuropsychology, 20, 485–503.

    Article  PubMed  Google Scholar 

  • Tombaugh, T. N., & McIntyre, N. J. (1992). The Mini-Mental State Examination: A comprehensive review. Journal of American Geriatric Society, 40(9), 922–935.

    Article  Google Scholar 

  • Tombaugh, T. N., McDowell, I., Krisjansson, B., & Hubley, A. M. (1996). Mini-Mental State Examination (MMSE) and the modified MMSE (3MS): A psychometric comparison and normative data. Psychological Assessment, 8, 48–59.

    Article  Google Scholar 

  • Tschanz, J. T., Welsh-Bohmer, K. A., Plassman, B. L., Norton, M. C., Wyse, B. W., & Breitner, J. C. S. (2002). An adaptation of the Modified Mini-Mental State Examination: Analysis of demographic influences and normative data: The cache county study. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 15(1), 28–38.

    PubMed  Google Scholar 

  • Uhlmann, R. F., Teri, L., Rees, T. S., Mozlowski, K. J., & Larson, E. B. (1989). Impact of mild to moderate hearing loss on mental status testing. Journal of the American Geriatrics Society, 37(3), 223–228.

    Article  PubMed  Google Scholar 

  • Weeks, D. L., Ambrose, S. B., Tindall, A. G., & Anderson, J. W. (2012). The utility of the Modified Mini-Mental State Examination in inpatient rehabilitation for traumatic brain injury. ACRM-ASNR Annual Conference Abstracts. Archives of Physical Medicine and Rehabilitation, 93(10).

    Google Scholar 

  • Woodford, H. J., & George, J. (2007). Cognitive assessment in the elderly: A review of clinical methods. Quarterly Journal of Medicine, 100(8), 469–484.

    Article  Google Scholar 

  • Yaffe, K., Fiocco, A. J., Lindquist, K., Vittinghoff, E., Simonsick, E. M., Newman, A. B., … & Harris, T. B. (2009). Predictors of maintaining cognitive function in older adults: The health ABC study. Neurology, 72, 2029–2035.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Andrea Coppens .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Her Majesty the Queen in Right of Canada

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Coppens, A., Williams, T.S., Sherman, E.M.S., Strauss, E. (2018). Modified Mini-Mental State Examination. In: Kreutzer, J., DeLuca, J., Caplan, B. (eds) Encyclopedia of Clinical Neuropsychology. Springer, Cham. https://doi.org/10.1007/978-3-319-56782-2_530-2

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-56782-2_530-2

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56782-2

  • Online ISBN: 978-3-319-56782-2

  • eBook Packages: Springer Reference Behavioral Science and PsychologyReference Module Humanities and Social SciencesReference Module Business, Economics and Social Sciences

Publish with us

Policies and ethics