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.

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?"

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.

There is no physical discomfort.

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

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:

• 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

There are no risks with these tests.

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.