Health Encyclopedia

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 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:

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.

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.

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