Conducting a Mental Status Exam

Impairment:

The patient failed to perform well on each portion of the MMSE test. With Orientation, Registration, and Recall scoring the lowest at 30%, 33%, and 33% of correct responses, respectively. The patient achieved a 60% score on attention and calculation and a 67% mark on language praxis.

Interpretation

This patient appears to have severe cognitive impairment based on the interpretation scale and an overall score of 15.

Diagnosis

An accurate diagnosis cannot be made using the information in the video and on the background sheet. We don’t have any background information, so we don’t know if the cognitive impairment developed gradually, suddenly, or if it was always present. We are unaware of any possible trauma.

Assuming that no other medical condition is causing the impairment, I would suspect possible Alzheimer’s disease in this patient. I was torn between delirium and Alzheimer’s disease.

I eventually ruled delirium out because the cognitive impairments were not accompanied by hyperactive or hypoactive symptoms.

There is clear evidence of memory and learning decline which are symptoms for Alzheimer’s patients. However, we can’t tell if this was a steady progression or if there’s another mixed etiology at work.

Conclusion

The results of this exercise were able to shed further insight on the use of the DSM-5 as a diagnostic tool. The patients results identified by the MMSE could have been suffering from a variety of various NCDs. In my opinion, the answer to the diagnosis was not clear, and it demonstrates the necessity of getting to know your client, obtaining an accurate history, and not relying on one source (the DSM-5) as a diagnostic guide.

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