Mental status testing

Definition

Mental status testing is done to check your thinking ability, and to determine if any problems are getting better or worse. It is also called neurocognitive testing.

Alternative Names

Mental status exam; Neurocognitive testing

How the test is performed

A nurse, physician, physician assistant, or mental health worker will ask a number of questions. The test can be done in the home, in an office, nursing home, or hospital. Sometimes, a psychologist with special training will do more extensive tests.

The most common test used is called the mini-mental state examination (MMSE) or Folstein test.

The following may be tested:

APPEARANCE

The health care provider will check your physical appearance, including:

• Age
• Dress
• General level of comfort
• Gender
• Grooming
• Height/weight

ORIENTATION

The health care provider will ask questions such as:

• What is your name?
• How old are you?
• Where do you work? 
• Where do you live?
• What day and time is it?
• What season is it? 

ATTENTION SPAN

Attention span may be tested earlier, because this fundamental skill can influence the rest of the tests.

The provider will want to test:

• Your ability to complete a thought
• Your ability to think and problem solve
• Whether you are easily distracted

You may be asked to do the following:

• Start at a certain number, and then begin to subtract backwards by 7s.
• Spell a word such as "WORLD" forward, and then backward.
• Repeat up to 7 numbers forward, and up to 5 numbers in reverse order.

RECENT AND PAST MEMORY

The provider will ask questions related to recent people, places, and events in your life or in the world.

Three items may be presented, and the person may then be asked to repeat them, and then recall them after 5 minutes.

The provider will ask about your childhood, school, or events that occurred earlier in life.

LANGUAGE FUNCTION

The provider will point to everyday items in the room and ask you to name them, and possibly to name less common items.

You may be asked to say as many words as possible that start with a certain letter, or that are part of a certain category, in 1 minute.

You may be asked to read or write a sentence.

JUDGMENT

This part of the test looks at your ability to solve a problem or situation. You may be asked:

• "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

How the test will feel

Why the test is performed

Normal Values

The most commonly used test, the mini-mental state examination (MMSE) or Folstein test, is scored from 0 to 30. The test is also divided up into sections, each one with its own smaller score. These results may help show which part of someone's thinking and memory may be affected.

What abnormal results mean

A number of health conditions can affect your mental status.

What the risks are

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.

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References

Snyderman D, Rovner B. Mental status exam in primary care: a review. Am Fam Physician. 2009;80:809-814.