Mental status tests

Mental status tests are used to see whether a disease or condition is affecting a person's thinking abilities. The tests can also reveal whether a person's mental condition is improving or getting worse.

The following tests may be performed.

ORIENTATION

The health care provider will ask questions that may include:

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

ATTENTION SPAN

The provider will test the person's ability to complete a thought. This may be evident through conversation, or the person may be asked 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 exercise alternative solutions to a given problem or situation, the provider might ask questions such as, "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?"

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.

There is no physical discomfort.

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

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
• 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 causes 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

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

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

RECENT AND REMOTE MEMORY

An underlying organic medical disorder may cause loss of recent memory when remote memory remains 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 aphasia. Some causes for aphasia include:

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

JUDGMENT

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

There are no risks associated with these tests.

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.