Mental status tests

Definition

Mental status tests are used to assess a person's thinking abilities, to see if a disease or condition is affecting them. The tests can tell your provider whether your condition is improving or getting worse.

How the test is performed

The following tests may be performed.

ORIENTATION

Your health care provider will ask you questions that may include:

• The time, date, and season
• The place where you live, type of building you are in, city and state you are in
• Your name, age, and occupation

ATTENTION SPAN

Your provider will test your ability to complete a thought. This may be evident through conversation, or you may be asked to follow a series of directions in order to base conclusions on your performance.

RECENT MEMORY

The memory of people, places, and events that have recently been involved in your life is called recent memory. Your provider will ask you questions related to recent events in your life or the world around you.

REMOTE MEMORY

The memory of people, places, and events that occurred earlier in your life is called remote memory. Your provider will ask you about your childhood, school, or historical events that occurred earlier in your life.

WORD COMPREHENSION

Word comprehension tests your knowledge of common items. Your provider will point to everyday items in the room and have you name them.

JUDGMENT

To test your judgment and ability to exercise alternative solutions to a given problem or situation, your provider might ask, "What would you do if a police officer approached from behind in a car with lights flashing?" or "If you found a driver's license on the ground, 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 distort the results of the test by making it appear that cognitive function has not diminished when, in fact, it actually has.

How the test will feel

There is no physical discomfort.

Normal Values

• Orientation to person, place, and time
• Normal attention span
• Intact recent memory
• Intact remote memory
• Normal word comprehension, reading, and writing
• Intact judgment

What abnormal results mean

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

ORIENTATION

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

• Alcohol intoxication
• Low blood sugar
• Head trauma or concussion
• Fluid and electrolyte imbalance
• Nutritional deficiencies -- particularly lack of niacin, thiamine, vitamin C, or vitamin B-12
• Hyperthermia (fever)
• Hypothermia -- a drop in body temperature can cause sudden confusion
• Hypoxemia -- chronic pulmonary disorders can produce persistent confusion
• Environmental (such as heat stroke, heavy metal poisoning, hypothermia, or methanol intoxication)
• Drugs (such as atropine, chloroquine, cimetidine, CNS depressants in large doses, cycloserine, oral digitalis medicines, indomethacin, lidocaine, withdrawal from narcotics and barbiturates)
• Organic brain disease

ATTENTION SPAN

If you are unable to complete a thought, or are easily distracted by other stimuli, you may have an abnormal attention span. This may have a number of causes. A few examples are:

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

RECENT AND REMOTE MEMORY

Organic syndromes are indicated if there is a loss of recent memory, but remote memory remains intact. Remote memory is lost when there is damage to the upper part of the brain as occurs in Alzheimer's disease. See also memory loss.

WORD COMPREHENSION, READING, AND WRITING

These tests screen for aphasia. Some causes for aphasia include:

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

JUDGMENT

We exercise judgment in all of our daily activities, and the ability to determine an appropriate course of action is vital to survival in many situations. The following are some causes of impaired judgment:

• Mental retardation
• Emotional dysfunction
• Schizophrenia
• Organic brain disease

What the risks are

There are no risks associated with these tests.

Special considerations

Some tests that screen for aphasia (problems with language due to brain dysfunction), such as those involving reading or writing, do not account for people that may never have been able to read or write. If you know that the person to be tested has never been able to read or write, notify 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.

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