August 11, 2008

Mini-Mental Status Exam: ORArL 2,3, RWD!

The components of the Mini-Mental Status Exam (or Folstein test) can be summarized in the quick and easy mnemonic: ORArL 2,3, RWD! It can be a part of a more comprehensive Mental Status Exam performed by psychiatrists as a screening tool assessing cognitive function.

O: Orientation to Person, Place and Time
R: Recognition (repeat three objects, i.e. balloon, Pong and happiness)
A: Attention (Serial 7s counting backward from 100 or spelling WORLD backwards)
r: recall (ask them to recall the three objects 5 minutes later)
L: Language
2: Identify the names of Two objects (pen and glasses/watch)
3: Follow a Three Step command (take this paper in your right hand, fold it in half and place it on the floor)
R: Reading (Read this statement and do exactly what it says: "Close your eyes")
W: Writing (Write a sentence)
D: Drawing (Copy a figure of two intersecting pentagons)

This is a useful series to memorize as you become proficient with various components of the MSE since it occupies the majority of your cognitive section. Most people will have a questionaire to fill out, but its easy to do it orally. I find it helpful to create mnemonics of all interview questions since a smooth Q&A session with your patients is a great way to imbue them with confidence in your skills (and any observing residents/attendings.)

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