Case 2 – Forgetfulness

You are about to see Mrs. Chambers, a 71 year old woman, in your outpatient clinic. She was brought in today by her husband who is concerned that she’s becoming increasingly forgetful. Take a focused history related to her husband’s complaint and perform the MMSE on Mrs. Chambers.

History

  • Asks patient if she concurs with husband’s concerns (she reluctantly agrees)
  • Asks patient about forgetfulness in daily context (e.g. misplace keys, forgets to turn off stove)
  • Asks about forgetfulness with dangerous house appliances (has previously left stove on)
  • Asks about forgetfulness with medications
  • Asks patient to personally assess her current daily function
  • Ambulation (uses cane)
  • Hygiene and dressing (independent)
  • Eating, cooking
  • Banking and shopping
  • Housework
  • Driving and transportation (still drives)
  • Assesses for polypharmacy
  • Visual acuity, dizziness
  • Continence
  • Falls (has fallen once)
  • Arthritis
  • Other past medical history
  • Mood changes (patient’s mood is ‘so-so’)
  • Alcohol use
  • Social support outside of husband (has 2 adult children)
  • Addresses patient’s reluctance to address her husband’s concerns

Mini Mental Status Examination

Introduces exam to patient and explains why they are performing the test

  • (/5) Orientation to Place: Country, Province/State, City, building, floor
  • (/5) Orientation to Time: year, season, month, day of the week, day
  • (/3) Registration: Three naming prompts, asks to repeat back
  • (/5) Attention: Asks to calculate serial 7s or spell WORLD backwards
  • (/3) Recall: Repeating previously remembered words
  • (/2) Language: Asks to name two objects of minimal difficulty
  • (/1) Repetition: Asks patient to repeat a phrase back
  • (/1) Complex Task: Draw intersecting pentagons for patient to copy
  • (/3) Comprehension: Patient to follow three step command
  • (/1) Writing: Patient writes sentences with proper syntax
  • (/1) Reading: Patient obeys simple written command

Compiles total score, correctly interprets results, and conveys results to patients

Case 2 – Forgetfulness