A friend shared a story today that I have heard many times before, and it bears repeating. My friend's father lives in another town. Family members have realized that he has been repeating himself a great deal, forgetting significant dates (birthdays, appointments), not paying bills and generally letting his house fall into disrepair. The family is worried about his memory. These forgetful behaviors are all new- totally out of character for this man. He went to see his doctor, and took the "mini-mental status" test, scoring nearly perfect, and so was reassured that there is no problem.
So what is the problem? The problem is that you can have fairly advanced dementia (memory loss) and STILL randomly score well on this quick memory test. Sadly, I remember that with our mom, she was still only missing a couple points when she no longer recognized that I was her daughter. The mini-mental status exam is a quick tool that is often used in the primary care setting to help us asses a patient's mental awareness and simple memory and calculating tools. If you score poorly on it, that is a huge red flag and catches our attention. The challenge for the physician is that we need to remember that this test does NOT RULE OUT dementia.
If a family is concerned and gives specific examples such as those listed above, we need to pursue further testing. In my office, that means lab work in our office a referral for full neuro-psychiatric testing.
BOTTOM LINE: A "normal" mini-mental status exam does NOT mean your memory is okay. Look at the big picture and give your doctor specific examples (write them down ahead of time) so he/she can better evaluate the seriousness of the problem.
Want to see the Mini-Mental Status test? http://www.gp-training.net/protocol/psychiatry/mini_mental_state.htm
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