Mental status tests

Definition:

A group of tests used to objectively measure mental function.

Alternative Names:

Remote memory; Recent memory; Word comprehension; Orientation; Attention span; Cognitive tests

How the test is performed:

Orientation:
Your health care provider will ask you all or some of the following questions:

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 your occupation

Attention Span:
Your health care provider will test your ability to complete a thought. This may be evident through conversation, or he may ask you to follow a series of directions, and base his conclusions on your performance.

Recent Memory:
This is the memory of people, places, and events that have recently occurred in your life. Your health care provider can easily test your remote memory by asking you questions related to recent events in your life or the world around you.

Remote Memory:
This is the memory of people, places, and events that occurred earlier in your life. Your health care provider can test your remote memory by asking about your childhood, school, or historical events that occurred earlier in your life.

Word Comprehension:
This tests your knowledge of common items. Your health care provider will point to every day items in the room and have you name them.

Judgment:
This test measures your judgment and ability to exercise alternative solutions to a given problem or situation. For example, your health care provider might ask you "what would you do if a police officer approached from behind in a car with lights flashing?" or "if you found a drivers license on the ground what would you do?"

How to prepare for the test:

No preparation is necessary for this test, all responses should be natural, spontaneous, and honest.

How the test will feel:

There is no physical discomfort.

Why the test is performed:

These tests are screening tools for cognitive impairment, and supply your health care provider with an objective measure of improvement.

Normal Values:

orientation to person, place, and time
a normal attention span
intact recent memory
intact remote memory
normal word comprehension, reading, and writing
intact judgment

What abnormal results mean:

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

alcohol intoxication
low blood sugar
head trauma or injury -- 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:

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:

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 cognitive tests. Some tests that screen for aphasia (varying levels of communication deficit due to brain dysfunction) such as reading or writing do not account for those that may never have been able to read or write. It is important that the health care provider is aware in such case so he does not make a misdiagnosis.

Special considerations:

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

Review Date: 5/26/2001
Reviewed By: Christos Ballas, M.D., Department of Psychiatry, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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