The mini-mental state examination (MMSE) from a language perspective: an analysis of test interaction

Assessment of language and cognitive abilities are associated with clinical challenges. The aim of the present study was to learn more about the MMSE test process from a language perspective by looking in detail at the interaction between patient and tester. In addition, we aimed to further explore the relationship between linguistic and cognitive difficulties. The study was based on an analysis of 20 MMSE test dyads, 10 persons with aphasia and 10 persons with dementia, in interaction with speech and language pathologists. All conversations were audio and video recorded and transcribed verbatim according to Conversation Analytical principles. The thorough analysis of the interactions highlighted some main findings that affected the communicative project of the test interactions. Finally, the test results were summarized and analyzed. Through the analysis, some particularly challenging aspects emerged; the understanding of the verbal instructions, the handling of the instructions and the evaluation of the answers. The test results demonstrated that there were no significant differences between the two groups of participants' MMSE results. The results in the 'language' category did not seem to capture the language disorders among many of the participants more than the remaining test items. By qualitative analyses of the interactional aspects of test situations, information about both cognitive and linguistic abilities that otherwise would have been overlooked may be revealed.