Mental State Examination

Question 1

1. Orientation

Answer 1

5 ( ) -What is the (year), (season), (month), (date), (day).
5 ( ) -Where are we: (country, county, city/town, building name, floor of the
building)

Question 2

2. Registration

Answer 2

3 ( ) -Ask if you can test the individual’s memory. Name 3 objects (e.g. apple, table,
penny) taking one second to say each one. Then ask the individual to repeat the names of all three
objects. Give one point for each correct answer. After this, repeat the object names until all three
are learned – up to 6 trials).

Question 3

3. Attention and calculation

Answer 3

5 ( ) -Spell ‘world’ backwards. Give 1 point for each letter that is in the right order
DLROW = 5, DLORW = 3).

Question 4

4. Recall

Answer 4

3 ( ) -Ask for the 3 objects repeated above. What were the 3 objects I asked you to
repeat a little while ago? Give 1 point for each correct object. (Recall should be tested five
minutes after presenting the words).

Question 5

5. Language -1

Answer 5

2 ( ) -Point to a pencil and ask the individual to name this object (l point).
Do the same with a wrist-watch (1 point).

Question 6

6. Language- 2

Answer 6

( ) -Ask the individual to repeat the following: ‘No ifs, ands or buts’ (l point).
You may repeat the phrase if the individual has difficulty hearing or understanding you, up to a
maximum of five times, but the score should be based only on the first attempt to repeat the
phrase.

Question 7

7. Language- 3

Answer 7

3 ( ) -Give the individual a piece of blank white paper and ask him or her to follow a
3-stage command. ‘Take the paper in your right hand, fold it in half with both hands and put the
paper down on your lap’ (1 point for each part correctly followed). Give only one trial.

Question 8

8. Language-4

Answer 8

1 ( ) -Show the individual the ‘CLOSE YOUR EYES’ message. Ask him or her to
read the message and do what it says (give 1 point if the individual actually closes his or her
eyes).

Question 9

9. Language-5

Answer 9

1 ( ) -Ask the individual to write a sentence on a blank piece of paper. The sentence
must contain a subject (real or implied) and a verb, and must be sensible. Punctuation and
grammar are not important (1 point).

Question 10

10. Language- 6

Answer 10

1 ( ) -Show the individual the intersecting pentagons and ask him or her to copy the
design exactly as it is (1 point). Each pentagon should have 5 sides and 5 clear corners and the
two shapes must intersect to score 1 point. Tremor and rotation are ignored.