Indian Journal of Physiotherapy and Occupational Therapy - An International Journal

Mini mental state examination (MMSE) is a brief neuropsychological screening tool that provides a quantitative assessment of cognitive impairment. In stroke patients it is widely used in early and late stages. Level of education and sociocultural background can affect diagnosis of cognitive impairment. In Indian population these may be the main limitations apart from economical aspect of MMSE purchase. In this narrative review we intend to look at the factors that may limit the use of this scale in Indian population with an emphasis to south Indians including the reasons behind limited use of Tamil version of MMSE.

Literature was searched for past 25 years, including terms Mini mental state examination, cerebrovascular accident, Cognition, CVA, stroke, brain injury, India, Tamil. Search was done in Pubmed, Embase, Cinhal, and Google Scholar. Cross references were retrieved. Studies using MMSE in Indian population, MMSE in stroke, studies with Tamil version of MMSE were considered for analysis.

12 studies meeting inclusion criteria were selected and they show that MMSE is used for assessment of cognitive impairment in stroke patients in India though there are too many limitations. It had a limited use as a diagnostic tool for cognitive impairment in south India and was barely used in Tamil Nadu. MMSE1 and MMSE2 require purchase. Few authors translated the MMSE1 scale into local languages to be overcome the linguistic barrier. In south Indian population only English version has been preferred, though Tamil version is available.

Studies evaluating cognitive impairment using MMSE in south Indian population were few in number. Studies which included south Indian population did not use Tamil version. Justification for not using tamil version of MMSE couldn't be identified. We propose use of tamil version of MMSE in South Indian population in view of dearth in literature and cultural implication during cognitive evaluation.