Learning Issue: What is Oriented x 4 Name: Michael Holmes • The advantages of the MMSE are short time of administration and quantitation, which is useful in documentation for insurance benefits, such as rehabilitative therapies or drug therapy, and for disability assessment. • Several disadvantages of the MMSE have been identified. First, the normal range of scores depends on education. The low-normal cutoff is estimated by Crum and colleagues (1993) to be 19 for uneducated people, 23 for graduates of elementary or junior high school, 27 for high school graduates, and 29 for college graduates. Age is also a factor. In addition, the test is weighted toward orientation and language, and results can be normal in patients with right hemisphere or frontal lobe damage. Finally, even an abnormal score does not distinguish a focal lesion from a more diffuse disorder, such as an encephalopathy or dementia. • One answer to the dilemma of mental status testing is to use the MMSE as a screening test and then
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Mental status examination, Bedside Mental Status Examination