Talk:Mini–Mental State Examination

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Does test score measure "dementia" or cognitive function?[edit]

My father age 87 just took this test. Cognitive function was the term used for what the test measured. Same with most of the medical studies I looked at for B12 and folate deficiency. It was described as measuring the subjects cognitive function.
This article relates score on test to dementia only. Real world the test is used not only for dementia but for a range of other issues that can impair cognitive function. Such as depression, nutrition etc. (talk) 22:06, 22 March 2008 (UTC)

I agree MMSE does not measure dementia. I have changed 'dementia' to 'cognitive impairment' in the article. (talk) 11:30, 21 November 2008 (UTC)


hey, nice surprise. nice article: should i put in some stuff i know from doing these tests? also working on a medical decision making wiki articleCulturejam

copyright issues[edit]

We've received a complaint of copyright violation from the publishers of the MMSE on m:OTRS. Please be careful not to provide so much detail in this article that we basically replicate the test! Thanks, mreplySpang 18:56, 17 June 2006 (UTC)

The publishers of the MMSE? This appeared in a medical journal several decades ago and (?illegal) sheets circulate in all hospitals. The version you removed was written originally by me based on other online sources. It does follow the 30 questions, but that's the whole point isn't it? JFW | T@lk 22:49, 17 June 2006 (UTC)
JFW wrote:
The publishers of the MMSE? This appeared in a medical journal several decades ago and (?illegal) sheets circulate in all hospitals.
I vaguely remember running into this sort of thing once before (when the med students here wanted to publish a small handbook) and I remember thinking it is a load of crap-- not that it isn't copyrighted and not that the publisher doesn't have rights, but that the medical profession standardizes on something like this and lets copyright get into the way of information sharing (which is essential for high quality care). In someways this reminds me of the gif patent. This sort of thing is why I think we need more open access journals.[1] Also, I think it is an argument for turning back the clock on copyright-- it used to be 20 years duration. Anyhoo-- that's my rant.
The MMSE's wording is copyrighted-- but the content of the MMSE isn't; I think JFW's version was alright-- and likely legal but IANAL. FreplySpang what is the text of the complaint? Can you link to it? Nephron  T|C 00:02, 18 June 2006 (UTC)
Thanks for alerting me to this conversation, Nephron, and providing the link to the discussion of its copyright [2] . No, I cannot link to the text of the complaint. It was not a formal "cease and desist" but a polite informal request. Whether or not you feel that copyright is a good thing for tests, Wikipedia still has to comply with it, even if every hospital out there doesn't. (Because we are a prominent website, our violations are far more visible.) I would strongly prefer to keep the description in a summarized version, rather than an itemized list of questions with point scores. Personally, I think it is a more readable article for a lay audience anyway. (There is probably room for expansion beyond the 1-sentence summary I put in!) I see no problem with describing the test, its history, its usage, and the controversy over its copyright status. But giving enough detail that someone could administer the test goes against the spirit of our copyright policy, and the principle that Wikipedia is not a how-to guide. FreplySpang 18:53, 21 June 2006 (UTC)
I understand the importance of following copyright law. If you had the impression I was suggesting that Wikipedia should violate the copyright you misunderstood me. Any case, I added a section about the copyright enforcement. As for Wikipedia is not a how-to guide - I think including the full test would have been appropriate (if it were NOT a copyright violation). Presenting the actual test is a good way of explaining it (as is done in the Abbreviated mental test score article) IMHO as (1) the test is short (2) the relative difficulty of the questions can be assessed more easily. Nephron  T|C 06:47, 22 June 2006 (UTC)

If you are thinking of using the pentagons in displayed- please be aware that they don't comply with the standard set out in the original test. These pentagons that support this article are actually more difficult to draw than the "real" ones from the orginal test.

Psychometric issues[edit]

It's interesting to see how much work was put into the copyright section, with the article still lacking the most important aspect: a psychometric and literature critique. I'll see how much I can put in, but I'm not overly familiar with the test (hence my visiting the article). dr.alf 04:18, 6 November 2006 (UTC)

Copyright revisited[edit]

I re-inserted material that explained the copyright status and enforcement that was removed without discussion. It appears there was an effort to muddle fair published criticism. Nephron  T|C 03:06, 1 September 2007 (UTC)

Copyright re-revisited, this time re the pentagons[edit]

A good-faith anon removed [[Image:InterlockingPentagons.png]], saying that it violated copyright and test security. However, there are problems with both of those ideas. (1) You can't copyright the idea of two pentagons overlapping; you can only copyright a specific drawing of that idea. But [[Image:InterlockingPentagons.png]] was created by a Wiki user and released as GFDL. Therefore there is no copyright issue. (2) As for test security, the fact that there is an interlocking-pentagons diagram on the MMSE, and the general idea of what it looks like, ceased to be a secret many years ago. Therefore I have reverted to the previous version. — ¾-10 01:35, 2 April 2008 (UTC)

lol I'm sort of an eavesdropper here. The article only appears on my watchlist because i deleted an April Fool(?) The test is mainly bullshit. I was puzzled as well by the test security issue. Are we to believe that the standardized test can be learnt by the cognitively disabled by rote? I completely agree that the InterlockingPentagons.png image fails every test of presumed copyright. The MMSE version (for descriptive purposes only) doesn't look like the image on the article even. -- BpEps - t@lk 02:43, 2 April 2008 (UTC)
I agree--I don't think the MMSE qualifies for Test Security...Test Security pertains to things like the IQ tests and the SAT and MCAT...things that aren't ubiquitous...things that would be rendered worthless if the test were to become public knowledge. If an examinee were to obtain a copy of the MMSE beforehand, the results would still be valid. Cheating would be more impressive than taking the test cold. Mauvila (talk) 19:41, 24 April 2008 (UTC)

Ineligible for copyright?[edit]

I'm not sure this question of whether this material was actually copyrighted has been settled. While the article that the test appeared in was copyrighted, US copyright law explicitly states:

(b) In no case does copyright protection for an original work of authorship extend to any idea, procedure, process, system, method of operation, concept, principle, or discovery, regardless of the form in which it is described, explained, illustrated, or embodied in such work.

I'm not a lawyer, but I think the MMSE would qualify here, and I think this caveat would also apply to general language (not specific language) that details the use of a procedure. (The idea that a procedure isn't protected, but any mention or recording of it is, would lead to an absurd situation IMO...) In terms of what language of the author's is protected, I would guess that it is the language that shows some originality and that is not a fundamental aspect of the procedure itself. In other words, the instructions to the doctor may be protected (in terms of specific wording), but the exact wording of what the doctor asks the patient is a fundamental aspect of this procedure, and regardless of originality, would be excluded from copyright... I guess this is analogous to a board game, where someone could copyright the manual and the specific graphics associated with it, but they wouldn't be able to copyright aspects of gameplay, including any phrases that one player is to say to another (e.g. "Go fish"). I agree that, for readability, the whole test isn't warranted, but it seemed everyone sort of caved in mighty quickly on this one. Mauvila (talk) 06:39, 17 April 2008 (UTC)

You go explain that to the company that runs amok protecting its intellectual copyright. JFW | T@lk 21:25, 29 May 2008 (UTC)

Alternatives to MMSE[edit]

There are ongoing issues with the use of the MMSE on the workfloor, and some suggest that there are other tools that may be used instead (see here for some examples). The 2007 JAMA review points out that the copyright issue might be a reason to use alternative assessment tools. JFW | T@lk 21:39, 29 May 2008 (UTC)

Yes - Development and validation of a brief cognitive assessment tool: the sweet 16. seems to correlate well with MMSE and IQCODE ( Informant Questionnaire on Cognitive Decline in the Elderly) and was designed to be open access but it seems that there is open and then there is reality.... "Psychological Assessment Resources, Inc (PAR), and without admission of any liability, the Sweet 16 instrument has been removed from the website and is no longer available for dissemination.". "Sweet 16" is a bit of a stupid name from a google pov unless you like pr0n. Fromthehill (talk) 19:18, 30 December 2011 (UTC)

OTRS ticket received[edit]

A second OTRS email has been received at 15:31 on 14/4/10 relating to the copyright of the MMSE. As such, and because Wikipedia respects requests from copyright holders, I have removed the text until the email has been resolved, but be aware that OTRS is not here to fight copyright battles on behalf of editors, merely to handle emails. If the company consider it a violation, it's the editor who added it that they'll take to court, not the Foundation. Chase me ladies, I'm the Cavalry (talk) 09:00, 16 April 2010 (UTC)

Statements to the effect that "your Wikipedia editing may get you sued/jailed for copyright violations/libel/obscenity/..." do not contribute to a collegial editing environment. If a listing of test items which does not quote from the test itself is somehow determined to be a copyvio, it would be appropriate to use administrative power to enforce its removal. If no copyvio is present, there's no legitimate reason why the text shouldn't be restored. In questionable situations such as this (asserted copyvio without obvious verbatim copying), consultation with the Wikimedia Foundation attorney might be appropriate. Under no circumstances should it be suggested to parties who feel aggrieved by Wikipedia editing that administrators/OTRS will not protect their rights, and that suing individual editors is only viable recourse -- such commentary chills legitimate editorial activity. Emily Jensen (talk) 04:41, 17 April 2010 (UTC)
I removed the text so that the people I'm communicating with at the other end of the ticket see that we're acting in good faith. I've asked for clarification from them on how this exactly violates their copyright. Nk3, I don't understand your post - if you have any exact questions, list them below, and I'll answer them. My sentence about OTRS not being here to 'fight' was in relation to this edit, which inevitably results in a very angry lawyer emailing OTRS, whereas this could easily be dealt with on the talk page without involving OTRS at all. Chase me ladies, I'm the Cavalry (talk) 14:46, 17 April 2010 (UTC)

I've received no response from the copyright holders to my question, "[Do you] consider abstract descriptions of the test questions as copyrighted, and if so, under what basis?". As far as I am aware under US law, ideas, methods, processes, concepts and discoveries are not copyrightable - only the actual wording of the test is. I have therefore closed the ticket and put the disputed section back in, no harm done. For reference, the OTRS ticket number is 2010041510032152. I should also add that I'm not acting as an admin here - merely as an OTRS volunteer! Chase me ladies, I'm the Cavalry (talk) 16:22, 19 April 2010 (UTC)

Link update[edit]

Since i have no account of the en.wikipedia: Please someone update the link to reference 14 (Mini-Mental State Exam (MMSE) Copyright, M. Smith, University of Iowa College of Nursing)

new link:

thx, greetings, David -- (talk) 22:23, 22 April 2010 (UTC)

Clarification needed[edit]

Text reads: "Below [27 points], scores can indicate severe (≤9 points), moderate (10–18 points) or mild (19–24 points) cognitive impairment." So, what about scores of 25 and 26 points? How are they described? – S. Rich (talk) 00:47, 9 May 2014 (UTC)