The Mini-Mental State Examination

To the Editor.— In response (Archives1982;39:1443-1445) to a letter by Ganguli and Saul (Archives1982;39:1442-1443), Robins and Helzer noted that the Mini-Mental State Examination,1incorporated into the Diagnostic Interview Schedule (DIS) to assess cognitive impairment, had been reported by Folstein et al to differentiate between pseudodementia and true organic brain syndromes. We would like to make that statement more specific. The Mini-Mental State Examination was designed as a clinical method for grading cognitive impairment. It produces a score that can be used to follow the course of patients or as a case detection technique after cutoff scores are established. In a clinical psychiatric setting, a low Mini-Mental score can be associated with many disorders including mental retardation, delirium, manicdepressive disorder, and schizophrenia, as illustrated by Folstein et al in their pre-DSM-IIIarticle in 1975.1,2However, on a medical unit like the one from which Ganguli and