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How to use the mini-mental State Examination a guide and teaching resource for aged care service providers in this the final part of the four-part series will cover using the results including interpreting the results and practical implications it should be noted that a score of less than 24 out of 30 or a marked decline from a previous score should prompt consideration of the need for medical review the following can be used as a guide to assist with interpreting the mini-mental State Examination score a score of between 24 out of 30 is considered to be within normal range from 20 to 23 mild cognitive payment is suggested score of 10 to 19 is suggestive of moderate cognitive impairment and a score of below 9 is suggestive of severe cognitive impairment the guide will not be valid if the person tested displays difficulties or limiting factors due to poor english language schools poor eyesight hearing acute ill health pain or the presence of a tremor a decline in cognitive functioning has been found to occur with normal aging and a potential best score for any individual is also related to the level of education achieved as shown in this table a person who achieved a fourth grade education only may be able to score at best 22 in their mid to late 50s declining to a best possible score of 19 out of 30 over the age of 84 whereas a person who achieved a college level of education may be able to achieve a best score of 29 out of 30 in their 50s declining to 27 out of 30 in their late 80s as a normal process the score obtained from the mini-mental State Examination does not relate directly to the functional abilities of the person people who score less than 20 may experienced if you'll tease with managing finances driving shopping preparing meals and managing their medications but may be able to manage other activities such as maintaining their hygiene grooming dressing and eating cognitive and functional deficits may not be apparent to others at an early stage if the decline has occurred gradually over a number of years particularly if there's been frequent contact with the person scores obtained on a mini-mental State Examination may be higher or lower than the norm and not accurately reflect the level of impairment that a person may display in a functional sense in dementia people may not necessarily complain of memory difficulties there may be a tendency to continue to try to get the right answer and be unperturbed by incorrect answers during the testing process in people with outs homers type dementia usually the first deficit is in short term memory or recall has demonstrated by difficulty in recalling the three items in question five disorientation - time is followed by a disorientation - place and language deficits start to appear later in a vascular type dementia the deficits are more patchy people may have speech and language problems earlier than an Alzheimer type dementia in delirium clouding of consciousness may be apparent with...