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Mini Mental State Examination

The Mini Mental State Examination (MMSE) is a widely used screening tool for assessing cognitive function and detecting cognitive impairment.
It evaluates various domains, including orientation, memory, attention, language, and visuospatial skills.
The MMSE is commonly used in clinical settings, research studies, and geriatric assessments to help identify and monitor cognitive changes over time.
It provides a quick, standardized method for healthcare professionals to assess an individual's cognitive status and can assist in the diagnosis and management of conditions such as dementia, Alzheimer's disease, and other neurocognitive disorders.
The MMSE is a valuable instrument in the evaluation and monitoring of cognitive function and can contribute to informed decision-making and patient care.

Most cited protocols related to «Mini Mental State Examination»

1
Cam-CAN Stage 2 Recruitment Protocol
The size of the study sample population required to reach 100 qualified participants per decile for Cam-CAN Stage 2 is expected to vary by age when accounting for exclusion and refusal, estimated population data, clinical based experience and estimates of individuals who may refuse to participate in neuroimaging. Numbers are adjusted for the proportion of the general population with exclusion criteria including MR safety contraindications (e.g. pacemakers), learning disability (living at home), cognitive impairment (Mini-Mental State Examination (MMSE) [8 (link)] score of 24 or less) and reduced response from individuals with limited longstanding illness or disability. Proportions are estimated based on data from the Office of National Statistics (ONS), the Medical Research Council Cognitive Function and Ageing Study (MRC-CFAS) [9 ] and the National Health Service (NHS) registrations. We assume that only 30% of the population will undertake the initial interview and of those who do, 40-50% will agree to take part in Stage 2 (age dependent). Numbers predicted to be needed for Stage 1 are shown in Table 2. The age group above age 88 are recruited to the same population proportion as the 78-87 decile, in order to enable cohort comparison with other population-based studies and investigation of the rare group of oldest old who are experiencing healthy ageing.

Estimated Stage 1 recruitment across the deciles to recruit 100 participants in each decile (age 18-87) for Stage 2

Decile 1 (18-27 years)Decile 2 (28-37 years)Decile 3 (38-47 years)Decile 4 (48-57 years)Decile 5 (58-67 years)Decile 6 (68-77 years)Decile 7 (78-87 years)Decile 8 (88+ years)
Contact7507758509501250140028501700
Interview250250275300400450850500

Estimates include numbers per decile to be contacted and interviewed.

The Cam-CAN structure provides sufficient sample size in each decile to separate age-related change from other sources of individual variation. A number of different comparisons can hypothetically be undertaken using this structure. All hypotheses are investigated at a power of 80% and α = 0.05: for linear regression, assuming the continuous data are standardised to a N(0,1) distribution, 100 per decile enables us to investigate i) a linear decline of ±0.04 across the age range; ii) a difference in linear regression slope of size ±0.06 between two risk factor groups with a prevalence of 50% (such as gender); iii) differences in the mean values of two groups (defined with 50% prevalence) of ±0.2; iv) for dichotomous outcomes with prevalence of 0.5 in one group to detect a difference of at least ±0.1. This sample is sufficiently large to be able to detect non-linear change with age, such as a change in rate of decline, and the required size to detect stability with age (to exclude a slope of up to ±0.03 per decile). Multiple hypotheses can also be undertaken, such that linear decline of slope 0.1 can be detected for 100 independent investigations protecting the type I error rate (false positives).
Shafto M.A., Tyler L.K., Dixon M., Taylor J.R., Rowe J.B., Cusack R., Calder A.J., Marslen-Wilson W.D., Duncan J., Dalgleish T., Henson R.N., Brayne C, & Matthews F.E. (2014). The Cambridge Centre for Ageing and Neuroscience (Cam-CAN) study protocol: a cross-sectional, lifespan, multidisciplinary examination of healthy cognitive ageing. BMC Neurology, 14, 204.
Publication 2014
Age Groups Cognition Disabled Persons Disorders, Cognitive Gender Health Services, National Learning Disabilities Mini Mental State Examination Pacemaker, Artificial Cardiac Safety
2
Alzheimer's Disease Research Cohort Protocol
Archival data were reviewed from 4248 consecutive participants recruited into the Mayo Clinic Alzheimer's Disease Research Center (ADRC) and Alzheimer's Disease Patient Registry (ADPR) database. The Rochester Mayo ADPR is responsible for recruiting dementia patients and non-demented control subjects for studies on the progression of Alzheimer's disease through the Department of Community and Internal Medicine and does not operate in Jacksonville. The Rochester and Jacksonville ADRC sites acquire dementia patients from Behavioral Neurology. The Jacksonville ADRC site also recruits community controls via churches and community agencies. The same inclusion/exclusion criteria are applied for normal controls across both recruitment sites and has been published extensively through analyses of the MOANS16 (link)-19 and MOAANS20 (link)-22 (link) data. Patients with memory concerns raised by either the patient themselves, a family member, or a physician undergo a comprehensive neurological evaluation and neuropsychological testing to confirm or rule out dementia and Alzheimer disease.
A total of 1141 individuals with 16 or more self-reported years of education were identified. The sample included 1064 (93%) individuals who self-identified as Caucasian and 77 (7%) who self-identified as African-American. Of the 1141 participants, 658 individuals (242 males and 416 females) had no dementia and were considered cognitively normal (see Ivnik et al.19 for full criteria used to define normal cognition). The remaining 307 (164 males and 143 females) carried diagnoses of dementia established via consensus among ADRC investigators and based on published diagnostic criteria. Diagnoses included 202 (66%) patients with probable Alzheimer's disease, 48 (16%) with dementia with Lewy bodies, 18 (6%) with frontotemporal dementia, 13 (4%) with vascular dementia, and 25 (8%) with other dementia etiologies. A sample of 176 patients (106 males and 70 females) diagnosed with Mild Cognitive Impairment (MCI) was also included for comparison purposes.
The total sample included 512 (45%) males and 629 (55%) females, with a mean age of 75.9 (SD=7.2) years and a mean self-reported education of 17.1 (SD=1.5) years. There were no significant between-group differences (dementia vs. no dementia) in terms of age, gender, or education.
While the MMSE was available in diagnostic meetings, the diagnosis of dementia (and particular subtype) was arrived at via consensus-based judgment taking into account information from the neurological examination, clinical interview, lab results, imaging, informant ratings of activities of daily living (ADLs), as well as neuropsychological test data. Therefore, the MMSE had minimal impact on diagnostic decisions in the dementia cohort and was not considered at all as part of the determination of control status.
O'Bryant S.E., Humphreys J.D., Smith G.E., Ivnik R.J., Graff-Radford N.R., Petersen R.C, & Lucas J.A. (2008). Detecting Dementia with the Mini-Mental State Examination (MMSE) in Highly Educated Individuals. Archives of neurology, 65(7), 963-967.
Publication 2008
African American Alzheimer's Disease Caucasoid Races Cognition Cognitive Impairments, Mild Dementia, Vascular Diagnosis Disease Progression Family Member Females Lewy Body Disease Males Memory Mini Mental State Examination Neurologic Examination Neuropsychological Tests Patients Physicians Pick Disease of the Brain Presenile Dementia
3
Neuropsychological Battery for Alzheimer's Disease Research
Considerations for compiling the ADNI neuropsychological battery included the following: 1. Coverage of the domains of interest (memory, executive functions, language, attention, and visuospatial abilities); 2. Adequate sampling of cognitive domains of interest in subjects who are normal or who have MCI or AD; 3. Can measure change over a 2–3 year period; 4. Avoid ceiling or floor effects; 5. Were efficient and met practical demands; 6. Were utilized in the AD Clinical Study (ADCS) MCI trial and worked well in that setting. Additionally, the tests are widely used in AD Centers (ADCs) that are required to collect a Uniform Data Set, to reduce the amount of testing needed for participants enrolled in ADNI from ADCs.
The RAVLT uses a 15-item list of unrelated words. This list is read to the participant, who is asked to recall aloud as many of the words as they can. The number of successfully recalled words is recorded. The list is then repeated, and the participant again asked to recall as many words as they can. This process is repeated for a total of 5 learning trials, resulting in 5 scores. Then the examiner reads a new list of 15 words to the participant (an interference word list), and the participant is asked to recall as many of these words as possible. The participant is then asked to recall the initial word list, and the number of words recalled is recorded. After thirty minutes of other testing, the participant is again asked to recall as many words from the initial list as they can. The two versions of the RAVLT include different versions of the initial and interference word lists.
The ADAS-Cog includes two different memory tasks. First is a word list learning task similar to but distinct from that of the RAVLT. The ADAS-Cog word list includes 10 unrelated words (rather than 15) that are printed on cards. The participant is asked to read them aloud (while in the RAVLT they are read to the participant) and to remember them. There are three learning trials (rather than five in the RAVLT). After five minutes (rather than 30) of unrelated testing, the participant is asked to recall as many words as possible from the list.
The second memory task included in the ADAS-Cog is a word recognition task. In this task, the participant is given 12 cards with words printed on them, and asked to read them aloud and to remember them. Then the target words along with 12 distractor words are shown to the participant, who is asked to indicate whether the word was one they were supposed to recall. Two scores are recorded: the number of target words correctly identified as being part of the list (i.e., true positives), and the number of distractor words correctly identified as not being part of the list (i.e., true negatives).
The three different versions of the ADAS-Cog include different lists of the 10 words for the list learning trial as well as different lists of the 12 words for the recognition task.
For logical memory, a brief fact-laden passage is read aloud once. The participant is asked to recall as many of the passage’s 25 elements as they can, and the number of elements correctly recalled is recorded. After 30–40 minutes of other cognitive testing, the participant is again asked to recall the passage, and the number of elements correctly recalled in this delay condition is recorded.
In the MMSE, 3 words are read to the participant, who is asked to repeat them. Distractor tasks are then administered, after which the participant is asked to spontaneously recall the three words. Scores of 1 point are recorded for each item correctly recalled, and 0 for each item not correctly recalled.
Crane P.K., Carle A., Gibbons L.E., Insel P., Mackin R.S., Gross A., Jones R.N., Mukherjee S., Curtis S.M., Harvey D., Weiner M, & Mungas D. (2012). Development and assessment of a composite score for memory in the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Brain imaging and behavior, 6(4), 502-516.
Publication 2012
Attention Cognition Executive Function Memory Mini Mental State Examination
4
Longitudinal Study of Cognitive Aging
Procedures for this longitudinal project have evolved over time. For the first 15 years of study, the inclusion criteria for this project (on enrollment) were: 1) age greater than 60 years; 2) absence of National Institute for Neurological and Communicative Disorders and Stroke–Alzheimer’s Disease and Related Disorders Association criteria for AD [11 (link)]; 3) absence of medical, neurological, and psychiatric conditions that affect cognition; 4) initial mental status examination scores above standard clinical cut points for dementia (e.g., Mini-Mental State Examination [12 (link)] MMSE> 24); 5) willingness to complete annual mental status examinations; and 6) brain donation at death (78% of donors also granted permission to remove other tissues). At enrollment, cerebrovascular disease (e.g., documented stroke or TIA) was exclusionary and even though treated hypertension was not exclusionary, overall vascular risks were low as reflected in their average (SD) modified Hachinski [13 (link)] score of 0.96 (±1.33; median=1.0). With the renewal of the ADC grant in 2000, annual neurological and medical examinations were initiated and the enrollment age was increased to age 70. Current participant enrollment inclusion and exclusion criteria are shown in (Table 2) and reflect the primary change in minimum age at enrollment.
Schmitt F.A., Nelson P.T., Abner E., Scheff S., Jicha G.A., Smith C., Cooper G., Mendiondo M., Danner D.D., Van Eldik L.J., Caban-Holt A., Lovell M.A, & Kryscio R.J. (2012). University of Kentucky Sanders-Brown Healthy Brain Aging Volunteers: Donor Characteristics, Procedures and Neuropathology. Current Alzheimer research, 9(6), 724-733.
Publication 2012
Blood Vessel Brain Death Cerebrovascular Accident Cerebrovascular Disorders Cognition Communicative Disorders Dementia Donors High Blood Pressures Mental Disorders Mini Mental State Examination Physical Examination Tissues Vaginal Diaphragm
5
Evaluating Solanezumab's Impact on Preclinical Alzheimer's
The primary objective of the A4 study is to test the hypothesis that solanezumab, administered as a 400-mg intravenous infusion every 4 weeks for 168 weeks, will slow cognitive decline compared with placebo in participants with preclinical AD. This objective will be assessed using a mixed model of repeated measures (MMRM) analysis of change in the ADCS-PACC score. The specific hypothesis of the A4 study is that there will be less of a decrease in the ADCS-PACC score at the end of the treatment period for participants treated with solanezumab than for participants treated with placebo.
Based on a review of the literature for cohort studies in “normal controls” who progressed to mild cognitive impairment or Alzheimer dementia, we determined that a composite measure sensitive to change in preclinical AD would likely require assessment of 3 key domains: episodic memory, executive function, and orientation. Previous studies19 (link)–21 (link) have reported evidence that both list learning and paragraph recall (measures of episodic memory) tend to decline 7 to 10 years prior to the diagnosis of MCI or Alzheimer dementia. Recent data from amyloid imaging studies25 (link)–29 (link) have reported a decline in multiple cognitive domains looking retrospectively at cognitive trajectories over 8 to 10 years prior to PET amyloid imaging22 (link)–24 (link) and prospectively over 1- to 3-year longitudinal follow-up.
Based on this review, we propose a composite of 4 measures that are well established as showing sensitivity to decline in prodromal and mild dementia, and with sufficient range to detect early decline in the preclinical stages of the disease. The ADCS-PACC includes:

The Total Recall score from the Free and Cued Selective Reminding Test (FCSRT) (0–48 words),20 (link),30 (link)

The Delayed Recall score on the Logical Memory IIa sub-test from the Wechsler Memory Scale (0–25 story units),31

The Digit Symbol Substitution Test score from the Wechsler Adult Intelligence Scale–Revised (0–93 symbols),32 and

The MMSE total score (0–30 points).33 (link)

The composite score is determined from its components using an established normalization method.34 (link) Each of the 4 component change scores is divided by the baseline sample standard deviation of that component, to form standardized z scores. These z scores are summed to form the composite. Thus, a change of 1 baseline standard deviation on each component would correspond to a 4-point change on the composite. In the A4 study, the ADCS-PACC will be administered at baseline and at 24, 48, 72, 96, 120, 144, and 168 weeks, alternating between 3 test versions.
Donohue M.C., Sperling R.A., Salmon D.P., Rentz D.M., Raman R., Thomas R.G., Weiner M, & Aisen P.S. (2014). The Preclinical Alzheimer Cognitive Composite: Measuring Amyloid-Related Decline. JAMA neurology, 71(8), 961-970.
Publication 2014
Alzheimer's Disease APP protein, human Cognition Delayed Memory Diagnosis Disorders, Cognitive Executive Function Fingers Hypersensitivity Intravenous Infusion Memory, Episodic Mental Recall Mini Mental State Examination Placebos Presenile Dementia solanezumab

Most recents protocols related to «Mini Mental State Examination»

1
Comprehensive Cognitive Assessment in Dementia
All included participants were evaluated using the Mini-Mental State Examination (MMSE). Detailed cognitive assessment was available for a subsample of participants in both the Paris cohort (total n=135: CU [n=14], MCI patients [n=64], dementia patients [n=57]) and the BIODEGMAR cohort (total n=139: CU [n=18], MCI [n=59], dementia [n=62]). In the Paris cohort, memory domain scores were evaluated using total immediate and delayed recall of Free and Cued Selective Reminding Test (FCSRT), and the delayed matching-to-samples 48 test (DMS 48) for visual memory testing. Executive function was assessed using forward and backward digit span, frontal assessment battery and letter and animal fluencies. The language domain was evaluated using the Dénomination Orale 80 test, a naming test. In BIODEGMAR cohort, memory domain was evaluated using total immediate and delayed recall of FCSRT and the Memory Impairment Screen; executive functions, with backward digit span, TMT A and B; language domain, with the Boston naming test. Z-scores were computed from the control group scores as a reference. Domain scores were obtained by averaging z-scores of the individual tests available results within that domain and the global cognition score by averaging the 3 domains’ z-scores.
Lantero-Rodriguez J., Vrillon A., Fernández-Lebrero A., Ortiz-Romero P., Snellman A., Montoliu-Gaya L., Brum W.S., Cognat E., Dumurgier J., Puig-Pijoan A., Navalpotro-Gómez I., García-Escobar G., Karikari T.K., Vanmechelen E., Ashton N.J., Zetterberg H., Suárez-Calvet M., Paquet C, & Blennow K. (2023). Clinical performance and head-to-head comparison of CSF p-tau235 with p-tau181, p-tau217 and p-tau231 in two memory clinic cohorts. Alzheimer's Research & Therapy, 15, 48.
Publication 2023
Animals Cognition Delayed Memory Executive Function Fingers Memory Memory Deficits Mental Recall Mini Mental State Examination Patients Presenile Dementia Vision Tests
2
Assessing Cognitive Function with MMSE
The Mini-Mental State Examination (MMSE) was used to assess global cognition [60 ]. It consists of 30 brief questions (verbal and pen/paper based) which are designed to measure a range of cognitive domains including attention and concentration, memory, language, visuo-constructional skills, calculations and orientation. The MMSE took approximately 5 min to administer. A score (out of 30) based on performance across the 11 components of the test (orientation to time, orientation to place, registration, attention and calculation, recall, naming, repetition, comprehension, reading, writing and drawing) was calculated for each participant. Total scores ranged between 0 and 30, with lower scores indicative of more severe cognitive impairment and scores of 25 or over indicating no cognitive impairment.
Neville C.E., Young I.S., Kee F., Hogg R.E., Scott A., Burns F., Woodside J.V, & McGuinness B. (2023). Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA): health assessment protocol, participant profile and patterns of participation. BMC Public Health, 23, 466.
Publication 2023
Attention Cognition Disorders, Cognitive Memory Mental Recall Mini Mental State Examination
3
Screening for Mild Cognitive Impairment Using MoCA
The Montreal Cognitive Assessment (MoCA) [61 (link)] is typically used as a rapid screening instrument for mild cognitive impairment. It is more sensitive than the MMSE to mild cognitive impairment [62 (link)]. It assesses different cognitive domains including attention and concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking, calculation and orientation. The test which included a combination of verbal and pen/paper based tests took approximately 5–10 min to complete. A score (out of 30) based on performance was calculated for each participant with lower scores indicating greater cognitive impairment and scores of 26 or over indicating normal cognitive functioning.
Neville C.E., Young I.S., Kee F., Hogg R.E., Scott A., Burns F., Woodside J.V, & McGuinness B. (2023). Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA): health assessment protocol, participant profile and patterns of participation. BMC Public Health, 23, 466.
Publication 2023
Attention Cognitive Impairments, Mild Disorders, Cognitive Executive Function Memory Mini Mental State Examination
4
Assessing Outcomes in Elderly CICW Patients
In addition to the above, we collected the following data: 1) nursing home admission following CICW discharge (yes vs. no); 2) transfer to a different hospital or death during CICW stay; 3) length of CICW stay; 4) living and economic status before CICW admission, based on interview with participants or their family members; 5) MMSE score, based on cognitive function assessment by psychologists using the Japanese version of the MMSE (24 (link)); and 6) primary illness for hospitalization.
Yasuoka M., Shinozaki M., Kinoshita K., Li J., Takemura M., Yamaoka A., Arahata Y., Kondo I., Arai H, & Satake S. (2023). Prediction of Nursing Home Admission Using the FRAIL-NH Scale Among Older Adults in Post-Acute Care Settings. The Journal of Nutrition, Health & Aging, 27(3), 213-218.
Publication 2023
Cognition Family Member Hospitalization Japanese Mini Mental State Examination Patient Discharge
5
Frailty and Home Admission in Older Adults
This single-center, prospective, observational cohort study included patients treated at the CICW of National Center for Geriatrics and Gerontology in Japan between July 2015 and November 2020. This registry was completed in November 2020 because CICW was converted to a care ward for patients with COVID-19. Written informed consent was obtained from all patients or their family members, as appropriate. Ethical approval was obtained from the relevant Ethics Committee of Human Research of the National Center for Geriatrics and Gerontology, Japan (No. 830).
Participants registered in the CICW database sequentially during the study period were retrospectively screened. The database was developed for a registry study that focused to clarify the association between frailty and home admission. The database contained information of participants with informed consent and those who were not planned to be discharged from the CICW within 2 weeks, were not in the terminal stage of life, or did not have a pacemaker. The CICW database included the information regarding skeletal muscle mass by using bioelectrical impedance analysis (BIA). We excluded patients having a pacemaker because BIA can cause interference with the pacemakers.
The exclusion criteria of this research were visualized in Figure 1 and were as follows: (1) age under 65 years, (2) living in nursing homes before CICW admission, (3) length of hospitalization of less than 2 weeks, (4) Mini-Mental State Examination (MMSE) score not performed or of 9 or less, (14 (link)) and (5) missing measurements. Missing items of MMSE were replaced to 0, because these missing data represented the lacked ability to finish the item (e.g., fracture of the dominant hand, visual impairment or disturbance of consciousness). Of the screened 717 participants, 167 were excluded due to age under 65 years (n=10), living in a nursing home before CICW admission (n=38), CICW stay of less than 2 weeks (n=40), MMSE not performed or MMSE scores ≤9 (n=53), and missing data for Geriatric Depression Sacle 15 (GDS15) or the Mini Nutritional Assessment-Short Form (MNA-SF) or the Functional Independence Measure (FIM) completing all FRAIL-NH components (n=26). Finally, 550 older adults (258 with robust, 97 with prefrail, and 195 with frail status) were included in the analysis.

Flowchart of inclusion and exclusion for this study

Yasuoka M., Shinozaki M., Kinoshita K., Li J., Takemura M., Yamaoka A., Arahata Y., Kondo I., Arai H, & Satake S. (2023). Prediction of Nursing Home Admission Using the FRAIL-NH Scale Among Older Adults in Post-Acute Care Settings. The Journal of Nutrition, Health & Aging, 27(3), 213-218.
Publication 2023
Aged Bioelectrical Impedance Consciousness COVID 19 Ethics Committees, Research Family Member Fracture, Bone Homo sapiens Hospitalization Low Vision Mini Mental State Examination Pacemaker, Artificial Cardiac Patients Skeletal Muscles

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More about "Mini Mental State Examination"

The Mini Mental State Examination (MMSE) is a widely used cognitive assessment tool that evaluates various domains, including orientation, memory, attention, language, and visuospatial skills.
It is a quick, standardized method for healthcare professionals to assess an individual's cognitive status and can assist in the diagnosis and management of conditions such as dementia, Alzheimer's disease, and other neurocognitive disorders.
The MMSE is commonly used in clinical settings, research studies, and geriatric assessments to help identify and monitor cognitive changes over time.
It provides valuable insights that can contribute to informed decision-making and patient care.
The MMSE is a versatile instrument that can be employed in conjunction with statistical software like SAS (version 9.4) and SPSS (versions 20, 22.0, 23, 21, 25, 19.0) to analyze and interpret cognitive data.
Researchers and clinicians can leverage the MMSE to evaluate cognitive function, track progression of neurocognitive conditions, and make more accurate assessments.
By utilizing the MMSE, healthcare professionals can gain a deeper understanding of an individual's cognitive abilities and develop more personalized treatment plans.
This cognitive assessment tool is an invaluable resource in the field of geriatrics and neurology.
The MMSE is also known by its abbreviation, 'MMSE', and is sometimes referred to as the 'Folstein test' or the 'Mini-Cog'.
It is a widely recognized and accepted instrument in the medical and research communities for evaluating cognitive impairment and monitoring cognitive changes over time.
With its ease of use and standardized approach, the MMSE continues to be a valuable asset in the assessment and management of neurocognitive disorders.