Unmapping the Mini-Mental State Exam (MMSE)

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

Unmapping the Mini-Mental State Exam (MMSE)

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

Pelaksanaan Senam Otak untuk Peningkatan Fungsi Kognitif pada Lansia dengan Demensia

Demensia merupakan gejala menurunnya daya ingat, berpikir, berperilaku, dan kemampuan melakukan aktivitas sehari-hari. Hilangnya kapasitas intelektual pada demensia tidak hanya terjadi pada memori, tetapi juga pada kognitif dan kepribadian. Salah satu upaya pencegahan penurunan kognitif pada demensia pada lansia adalah dengan melakukan senam otak. Metode yang digunakan yaitu studi deskriptif dengan pendekatan proses asuhan keperawatan pada dua lansia sebagai subjek studi. Subjek studi diambil berdasarkan kriteria inklusi dan eksklusi kemudian dilakukan intervensi selama seminggu dengan memberikan tindakan keperawatan berupa senam otak selama 15 menit setiap satu kali dalam sehari. Pengumpulan data dilakukan melalui wawancara, observasi, dan asuhan keperawatan. Fungsi kognitif diukur dengan menggunakan instrumen Mini Mental State Exam (MMSE). Hasil studi menunjukkan senam otak dapat meningkatkan fungsi kognitif pada lansia demensia yang ditunjukkan dengan peningkatan skor MMSE pada kedua subjek studi. Kesimpulan dari studi ini yaitu setelah dilakukan intervensi senam otak selama seminggu, skor MMSE meningkat dengan kisaran 0-16. Intervensi senam otak ini dapat direkomendasikan secara teratur bagi lansia agar dapat meningkatkan fungsi kognitif secara optimal.

HUBUNGAN ANEMIA DENGAN FUNGSI KOGNITIF PADA PASIEN YANG MENJALANI TERAPI HEMODIALISIS DI RST DR. REKSODIWIRYO PADANG

Salah satu komplikasi penyakit Gagal Ginjal Terminal yang menjalani hemodialisis adalah anemia. Anemia menyebabkan transfer oksigen ke otak terganggu yang berdampak pada penurunan konsentrasi dan penurunan fungsi kognitif. Tujuan dari penelitian ini adalah untuk mengetahui hubungan anemia dengan fungsi kognitif pada pasien yang menjalani terapi Hemodialisis di RST Dr. Reksodiwiryo Padang. Jenis penelitian ini adalah cross sectional. Penelitian ini dilakukan pada bulan Desember 2018 – Juli 2019 di ruangan Hemodialisa RST Dr. Reksodiwiryo Padang. Sampel pada penelitian ini berjumlah 42 orang dengan menggunakan metode ”purposive sampling”. Instrumen penelitian yang digunakan adalah kuesioner Mini Mental State Exam (MMSE). Analisa secara univariat ditampilkan pada tabel distribusi frekuensi dan bivariat dengan menggunakan uji chi-square dengan kepercayaan 95%. Hasil penelitian menunjukkan lebih dari separuh (61,9%) responden mengalami gangguan fungsi kognitif berat, sebagian besar (78,6%) responden mengalami anemia dan terdapat hubungan anemia dengan fungsi kognitif pada pasien yang menjalani terapi hemodialisis di RST Dr. Reksodiwiryo Padang (p<0,05). Kesimpulan dari hasil penelitian anemia mempengaruhi fungsi kognitif pasien Gagal Ginjal Terminal yang menjalani terapi hemodialisis. Diharapkan kepada perawat dapat memberikan edukasi kepada pasien tentang cara mengatasi anemia dan mempertahankan fungsi kognitif.

PENGARUH SENAM OTAK TERHADAP PENURUNAN TINGKAT DEMENSIA

Demensia berhubungan dengan fungsi otak, karena kemampuan lansia untuk berpikir akan dipengaruhi oleh keadaan otak. Peningkatan daya kognitif dapat dilakukan salah satunya dengan senam otak (brain gym). Penelitian ini bertujuan untuk mengetahui pengaruh senam otak terhadap penurunan tingkat demensia pada lansia di Wilayah Kerja Puskesmas Kesambi Kota Cirebon Tahun 2017.Jenis penelitian ini menggunakan desain penelitian quasi eksperimental design yaitu dengan pendekatan one group pretest posttest design menggunakan satu kelompok subjek. Pengambilan sampel menggunakan total sampling dengan jumlah sampel 25 responden. Metode pengumpulan data dengan wawancara dan demensia diukur dengan MMSE (Mini Mental State Exam) Analisis data yang digunakan adalah uji Paired Samples Test.Hasil penelitian menunjukkan sebelum dilakukan intervensi lansia dengan demensia ringan 9 orang (36%), setelah dilakukan intervensi lansia dengan demensia ringan 14 orang (56%). Dari hasil uji statistik didapatkan nilai p value adalah 0,011 dengan demikian p value < 0,05 yang berarti terdapat pengaruh senam otak terhadap penurunan tingkat demensia pada lansia di Wilayah Kerja Puskesmas Kesambi Kota Cirebon Tahun 2017.Kata Kunci : Senam Otak, Demensia ABSTRACTDementia is associated with brain function. It is because the ability of the elderly to think will be influenced by the state of the brain. To inprove cognitive power can be done by doing such as with brain gym. This study is aimed to determine the effect of brain gymnastics to the decrease rate of dementia on the elderly in Puseksmas Kesambi Cirebon in the year of 2017.This research uses quasi experimental research which is designed by approaching one group pretest and another group using one group of subjects. To get the sample the research used total sampling with a sample of 25 respondents. Dementia is measured by the MMSE (Mini Mental State Exam). The analysis of the data which was used is paired samples test.The results showed, before conducting the threatment, there were 9 people of the elderly with the mild dementia category or its amount (36%). Moreover, after conducting the treatment, there were 14 people of the elderly with the mild dementia category or it is amount (56%). From the test results obtained statistical p value is 0,011 thus p value < 0,15. Which means that there is a brain gym influence on the elderly in Puseksmas Kesambi Cirebon in the year of 2017.Keywords : Brain Gym, Dementia

Performance on the mini-mental state exam and the Montreal cognitive assessment in a sample of old age psychiatric patients

Objective: This study assesses to what extent the Mini-Mental State Exam and the Montreal Cognitive Assessment scores may predict the presence of dementia in a sample of typical old age psychiatric patients who may or may not have temporally or permanently reduced cognitive abilities. Methods: A total of 141 inpatients completed the Mini-Mental State Exam and the Montreal Cognitive Assessment at arrival. All patients were subsequently diagnosed during their stay at the age-psychiatric unit. Receiver operating characteristics and analysis of variance were used to compare the results of the two tests for different patient groups. Results: The Montreal Cognitive Assessment is slightly more sensitive and specific than the Mini-Mental State Exam for dementia prediction. Age, sex, and education only account for approximately 2% of the variance in both tests. Patients with more than one diagnosis across the diagnostic groups included in this study (dementia, psychoses, affective disorder, and depression) performed significantly poorer on both tests than patients with a single diagnosis. Conclusions: Both tests are efficient in detecting cognitive impairment, but neither test can effectively exclude other reasons for low test results in our sample of elderly psychiatric patients. The sensitivity for ruling out dementia is 27 points for the Mini-Mental State Exam and 23 points for the Montreal Cognitive Assessment in the current patient sample.