The Mini-Mental Status Examination (MMSE) is a brief, structured test
of cognitive function. The test is often used as a screening or case-f
inding instrument for the detection of organic mental disorders or cog
nitive impairment. However, many clinicians incorporate the MMSE into
their clinical mental status examination. In both contexts, cutoff sco
res are often utilized to interpret the results, with scores below the
cutoff being interpreted as evidence of cognitive dysfunction, and sc
ores above the cutoff being interpreted as evidence against such dysfu
nction. However, when the test is done as part of a mental status exam
ination, the application of a cutoff score fails to take account of pr
ior clinical information, which is critical to the interpretation of a
ll diagnostic tests. In this paper, an alternative approach to interpr
etation is proposed. In the proposed method, guidelines for interpreta
tion are based on the probability of being free of organic disease at
each potential score. Scores are interpreted in terms of their consist
ency or inconsistency with a prior diagnostic impression. This takes p
rior clinical information and clinical judgment into account. Although
different from the traditional way of interpreting the MMSE, the prop
osed method can be implemented on an intuitive level and does not requ
ire mathematical calculations, which are inconvenient at the bedside.