A 70-year-old woman brought by her family reports progressive forgetfulness over two years. She scores 19 out of 30 on the Folstein Mini-Mental State Examination (MMSE). This score is BEST interpreted as:
- A Significant cognitive impairment warranting evaluation for dementia ✓
- B Borderline performance requiring no follow-up
- C Normal age-appropriate cognition
- D Pathognomonic of delirium
Correct answer: A. Significant cognitive impairment warranting evaluation for dementia
Explanation
The MMSE has a maximum score of 30, and a conventional cutoff below 24 indicates cognitive impairment. C score of 19 lies clearly below this cutoff, so it points to significant impairment and justifies a full dementia workup including imaging, thyroid and vitamin B12 assessment. The MMSE cannot itself separate delirium from dementia; delirium requires acute onset with fluctuating consciousness, which the history does not support.
Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.