Validation Study of the Mini-Mental State Examination in Urdu Language for Pakistani Population

Safia Awan 1, Naila Shahbaz , Syed Wasim Akhtar 3, Arsalan Ahmad 4, Sadaf Iqbal 5, Sellal Ahmed 6, Haider Naqvi 7, Mohammad Wasay 8, *
1 Department of Medicine, Neurology, Psychiatry, Aga Khan University, Karachi
2 Department of Neurology, Dow University of Health Sciences, Karachi
3 Neurology Section, Department of Medicine, Karachi Medical & Dental College and Abbasi Shaheed Hospital, Karachi
4 Department of Neurology, Shifa International Medical College and Hospital, Islamabad
5 Department of Neurology and Geriatrics, Liaquat National Hospital, Karachi
6 Geriatrics, Liaquat National Hospital, Karachi
7 Psychiatry, Aga Khan University, Karachi
8 Neurology, Psychiatry, Aga Khan University, Karachi

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© Awan et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Research, GITE/Burn Surgery, UC Denver, USA; E-mail: Address correspondence to this author at the Department of Neurology, Aga Khan University, Stadium Road, Karachi 74800, Pakistan; Tel: 9221 4930051(office), 92333 2234688(mobile); E-mail:


Validation study of the Mini-Mental State Examination in Urdu language for Pakistani population


This study was conducted primarily to validate and determine the optimal cutoff score in the diagnosis of dementia among Pakistani’s and study the effects of gender and education on the MMSE performance in our population.


Four hundred participants took part in the study. Patient with dementia recruited from five major hospitals from Pakistan. The MMSE was translated into Urdu.


There were 61 men and 39 women in dementia group and 225 men and 75 women in the control group. The mean score of Urdu MMSE were lower in patients with dementia 18.5 ± 5.6 (range 0-30) as compared to the controls 26.8 ± 2.6 (range 7-30). This difference between groups was statistically significant (p<0.001). Educational based MMSE score below 15 yielded perfect sensitivity and specificity for the diagnosis of dementia.


These finding confirm the influence of level of education on MMSE score and education stratified cutoff scores should be used while screening for cognitive impairment in this population.

Keywords: Mini mental status examination, cognitive function, dementia, mental disorders, validation tool.