Not All Days Were Created Equal - Better Day Orientation Following the Weekend on Mini-Mental State Examination (MMSE)

Objective: The aim of this study was to test whether patients are better oriented to the day on the first working day following the weekend (in Israel - Sunday), compared with other weekdays, on the Mini-Mental Score Examination (MMSE). Methods: All MMSE scores from November 2016 until December 2022 in our mental health center's computerized system were collected. The proportion of correct answers to orientation to the day was compared between weekdays. Results: The cohort consisted of 2049 MMSEs taken by 1376 patients [average age 80.3 (SD=9.3), 56.4% female]. The difference between the proportion of correct and incorrect answers was statistically significant between the days, of which Sundays showed a larger difference (53.4%) compared with the other days (χ²=20.77, P<0.001, Cramer V=0.104). A statistically significant odds ratio (OR) for providing a correct response was found for Sundays (OR=1.55, P=0.001) and, to a lesser extent, on Thursdays (OR=1.29, P=0.01). The difference between Sundays and other weekdays disappears as the total MMSE decreases. Conclusion: Day orientation on the MMSE may be better on the first day following the weekend, especially in early cognitive decline. Clinical Implications: The weekday in which the MMSE is performed may influence its results.