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Mental status tests
Definition
Mental status tests are used to determine whether a disease or condition is affecting a person's thinking abilities, and whether a person's mental condition is improving or getting worse.
Alternative Names
Memory; Word comprehension; Orientation; Attention span; Cognitive testsHow 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 Results
- 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:
- 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
Risks
There are no risks with these tests.
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.
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.
