Dementia Test

Dementia Rating Form

Please ONLY complete this form when asked to do so by your GP.

The Mini-Mental Status Examination (MMSE) or Folstein Test is a fast and simple test to quantify cognitive function and loss as occurs in the early stages of Alzheimer’s and other dementias. This free, online version of the standardised MMSE makes it easy to administer, score, receive and save the results.

This test requires:

An administrator, but the administrator needs no special training.
A blank sheet of paper and a pen or pencil.
Approximately 15 minutes to complete.

The questions are designed to be answered quickly, so the administrator should fill in each box immediately with the answer provided by the individual taking the test.

Scoring is calculated automatically and provided immediately upon completion of the test.

First Name *

Last Name *

Email *

Enter Email

Date of birth *

Please use format day/month/year e.g. 12/05/1979

Phone Number *

Full Name of Administrator

If you are human, leave this field blank.