What are cognitive screening tests?

The Mini-Mental State Examination, or MMSE, is an 11-item test of thinking skills scored out of 30, commonly used as part of an evaluation for possible dementia. A Cochrane review describes it as covering attention and orientation, memory, registration, recall, calculation, language and copying a drawing. It takes about five to seven minutes. It is a screening tool and does not diagnose dementia on its own.

There is no single dividing line, but cut points of 24 and 25 are the ones most often reported. In a Cochrane review of community studies, a cut point of 24 picked up 85% of people with dementia and correctly cleared 90% of people without it. The reviewers concluded the MMSE helps toward a diagnosis but should not be used alone to confirm or rule out dementia.

Both are 30-point screening tests. The Montreal Cognitive Assessment, or MoCA, takes about 10 minutes and assesses short-term memory, visuospatial and executive function, attention, language and orientation. A Cochrane review notes MoCA scores of 26 or above count as normal, and at that threshold it caught most dementia cases but also flagged many people without dementia. The MMSE is now protected by copyright, which may reduce its use.

The MoCA tests short-term memory, visuospatial skills, executive function, attention, concentration and working memory, language and orientation, according to a Cochrane review. It is scored out of 30, takes about 10 minutes, and adds one or two points for people with fewer years of formal education. A score of 26 or above is considered normal; a lower score suggests the person needs a fuller evaluation.

Yes. Medicare.gov says the yearly Wellness visit includes a cognitive assessment to look for signs of dementia, and you pay nothing for that visit if your provider accepts assignment. If the provider thinks you may have cognitive impairment, Medicare covers a separate, more thorough visit to review cognitive function and check for conditions like dementia, depression, anxiety or delirium. Part B costs apply to that second visit.