Unmapping the Mini-Mental State Exam (MMSE)

Abstract

This study is a critical discourse analysis of the Mini-Mental State Exam (MMSE), an assessment tool used to screen older adults for cognitive impairment worldwide. In it, I deconstruct and unmap two unofficial versions of the MMSE to reveal how its discursive practices are grounded in ageism, ableism, sanism, and other forms of oppression. I challenge the MMSE’s status as a neutral container for knowledge by uncovering how it actively defines “cognitive impairment” and “cognitively impaired” identity formation through epistemic violence. I discuss five key issues: consent, scoring, claims-making, voice, and copyright. Lastly, I reflect on how hegemonic discourses about “dementia” keep older adults and people with cognitive impairments in their social place while maintaining the multi-billion dollar “care” industry. This study highlights how social workers are implicated in injustices against older adults that are often hidden. I hope it will be the impetus for transformative change in this field. Keywords: Mini-Mental State Exam, short cognitive test, discourse analysis, unmapping, cognitive impairment, older adults, gerontology, anti-oppressive practice