Mental status tests

• Alternative Names

  Memory; Word comprehension; Orientation; Attention span; Cognitive tests

• How the test is performed

  The following tests may be performed:

  APPEARANCE

  The health care provider will check the person's physical appearance, including:

  • Age
  • Dress
  • General level of comfort
  • Gender
  • Grooming
  • Height/weight

  ORIENTATION

  The health care provider will ask questions that may include:

  • The person's name, age, and job
  • The place where the person lives, type of building, city, and state
  • The time, date, and season

  ATTENTION SPAN

  The provider will test the person's ability to finish a thought, either through conversation, or by asking the person to follow a series of directions.

  RECENT MEMORY

  The provider will ask questions related to recent people, places, and events in the person's life or in the world.

  REMOTE MEMORY

  The provider will ask about the person's childhood, school, or historical events that occurred earlier in life.

  WORD COMPREHENSION

  The provider will point to everyday items in the room and ask the person to name them.

  JUDGMENT

  To test the person's judgment and ability to solve a problem or situation, the provider might ask questions such as:

  • "If you found a driver's license on the ground, what would you do?"
  • "If a police officer approached you from behind in a car with lights flashing, what would you do?"
• How to prepare for the test

  No preparation is necessary for these tests. All responses should be natural, spontaneous, and honest.

  Preparation, especially by a highly intelligent person, could change the results of the test by making it seem that mental function has not declined when it actually has.

• How the test will feel

  There is no physical discomfort.

• Normal Values
  • Orientation to person, place, and time
  • Normal attention span
  • Normal judgment
  • Normal recent memory
  • Normal remote memory
  • Normal word comprehension, reading, and writing
• What abnormal results mean

  Each test can identify different possible problems, as described below.

  ORIENTATION

  Typically, orientation to time is first to be lost, followed by orientation to place, then to person. There are many possible causes for disorientation:

  • Alcohol intoxication
  • Drugs such as:
    • Atropine
    • Chloroquine
    • Cimetidine
    • CNS depressants in large doses
    • Cycloserine
    • Indomethacin
    • Lidocaine
    • Oral digitalis medicines
    • Withdrawal from narcotics and barbiturates
  • Environmental causes such as:
    • Heat stroke
    • Heavy metal poisoning
    • Hypothermia
    • Methanol poisoning
  • Fluid and electrolyte imbalance
  • Head trauma or concussion
  • Low blood sugar
  • Low oxygen in the blood (hypoxemia)
  • Nutritional deficiencies, especially lack of:
    • Niacin
    • Thiamine
    • Vitamin B12
    • Vitamin C
  • Organic brain syndrome

  ATTENTION SPAN

  People who are unable to complete a thought, or are easily distracted, may have an abnormal attention span. This may have a number of causes, including:

  • Attention deficit disorder (ADD)
  • Confusion
  • Histrionic personality disorder
  • Manic depressive illness
  • Schizophrenia

  RECENT AND REMOTE MEMORY

  A medical disorder may cause loss of recent memory but keep remote memory intact. Remote memory is lost when damage to the upper part of the brain occurs in diseases such as Alzheimer's disease.

  See also: Memory loss

  WORD COMPREHENSION, READING, AND WRITING

  These tests screen for language disorder (aphasia). Some causes of aphasia include:

  • Head trauma
  • Senile dementia (Alzheimer's type)
  • Stroke
  • Transient ischemic attack

  JUDGMENT

  The ability to decide the right course of action is important to survival in many situations. The following are some causes of impaired judgment:

  • Emotional dysfunction
  • Mental retardation
  • Organic brain syndrome
  • Schizophrenia
• What the risks are

  There are no risks with these tests.

• Special considerations

  Some tests that screen for language problems using reading or writing do not account for people who may never have been able to read or write. If you know that the person being tested has never been able to read or write, tell the health care provider in advance.

  If your child is having any of these tests performed, it is important to help him or her understand the reasons for the tests.

Review Date: 2/13/2008

Reviewed By: Luc Jasmin, MD, PhD, Departments of Anatomy & Neurological Surgery, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.