From the Guidelines
A Mini-Mental State Examination (MMSE) score of 24/30 indicates mild cognitive impairment, suggesting a need for further assessment to determine the cause and extent of cognitive changes. This score falls at the borderline between normal cognition and mild impairment, as the generally accepted cutoff for normal cognitive function is 24 or above, according to guidelines for managing Alzheimer's disease 1. However, interpretation should consider the individual's age, education level, and baseline functioning. For someone with higher education or previous high cognitive abilities, a score of 24 might represent a more significant decline than for someone with less education.
Some key points to consider with an MMSE score of 24/30 include:
- The score suggests the person can still manage most daily activities but may be experiencing noticeable difficulties with memory, attention, language, or other cognitive domains.
- Further assessment is recommended, including more comprehensive neuropsychological testing, to determine the cause and extent of cognitive changes, as the MMSE has limitations in detecting mild dementia and is not specific for Alzheimer’s disease or dementia 1.
- Potential causes could include early dementia, medication side effects, depression, or other medical conditions.
- Regular follow-up testing every 6-12 months would be valuable to monitor for any progression in cognitive decline, as recommended for managing Alzheimer’s disease 1.
- Early intervention with cognitive stimulation activities and addressing modifiable risk factors like cardiovascular health can be beneficial regardless of the underlying cause.
From the Research
MMSE Score Interpretation
A Mini-Mental State Examination (MMSE) score of 24/30 is considered to indicate some level of cognitive impairment. The MMSE is a widely used test for assessing cognitive function, with scores ranging from 0 to 30, where higher scores indicate better cognitive function.
Diagnostic Accuracy
- The diagnostic accuracy of the MMSE at various thresholds for detecting dementia has been studied extensively 2, 3, 4.
- A study found that at a cut point of 24, the MMSE had a sensitivity of 0.85 and a specificity of 0.90 for diagnosing dementia in community settings 2.
- Another study reported that the MMSE had a pooled sensitivity of 79.8% and a specificity of 81.3% for diagnosing dementia in memory clinic settings 4.
Cognitive Impairment
- An MMSE score of 24/30 may indicate mild cognitive impairment, but it is essential to consider the individual's overall clinical presentation and other diagnostic criteria 5, 6.
- The MMSE should not be used as a standalone diagnostic tool for dementia, but rather as part of a comprehensive diagnostic evaluation 6.
Limitations and Considerations
- The MMSE has limitations, including being highly verbal and not equally sensitive to all types of cognitive impairment 6.
- Scores can be affected by age, education, and cultural background, but not gender 6.
- The MMSE is best used as a screening tool to identify individuals who may require further evaluation, rather than as a definitive diagnostic test 2, 4.