Which Mini-Mental State Exam (MMSE) items can be used to screen for delirium and cognitive impairment?

Peter Fayers, M. J. Hjermstad, A. H. Ranhoff, S. Kaasa, L. Skogstad, P. Klepstad, J. H. Loge

Research output: Contribution to journalArticlepeer-review

53 Citations (Scopus)


Cognitive impairment is common in palliative care patients, but it is frequently undetected. The clinical consequence is that psychiatric states such as delirium, which often present with cognitive impairment, are inadequately treated. A short and simple questionnaire for screening of cognitive impairment is required for these patients, in order to proceed with more advanced testing if necessary. In this study, we explored the results from two samples of patients (n = 290 and n = 217) who had completed the Mini-Mental State Examination (MMSE). Cases of cognitive impairment are considered indicated by an MMSE score of less than. 24 of the total 30. We found that caseness could be fairly accurately screened by using four of the original 20 MMSE items, and that a six-item questionnaire further greatly improved the discrimination.(c) 2005 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Original languageEnglish
Pages (from-to)41-50
Number of pages10
JournalJournal of Pain and Symptom Management
Issue number1
Early online date25 Jul 2005
Publication statusPublished - Jul 2005


  • Mini-Mental State Examination
  • MMSE
  • palliative care
  • delirium
  • cognitive impairment


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