Mental status testing
Mental status testing is done to check a person's thinking ability, and to determine if any problems are getting better or worse. It is also called neurocognitive testing.
Mental status exam; Neurocognitive testing
How the Test is Performed
A nurse, doctor, 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 detailed tests.
The most common test used is called the mini-mental state examination (MMSE) or Folstein test.
The following may be tested:
The health care provider will check your physical appearance, including:
General level of comfort
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 may be tested earlier, because this fundamental skill can influence the rest of the tests.
The provider will check:
- 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 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.
You may be shown three items and asked to say what they are, and then recall them after 5 minutes.
The provider will ask about your childhood, school, or events that occurred earlier in life.
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 in a certain category, in 1 minute.
You may be asked to read or write a sentence.
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 car with lights flashing came up behind your car, what would you do?"
Some tests that screen for language problems using reading or writing do not account for people who do not read or write. If you know that the person being tested cannot read or write, tell the health care provider before the test.
If your child is having the test, it is important to help him or her understand the reason for the test.
The MMSE test is scored from 0 to 30. The test is also divided into sections, each with its own score. These results 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. The health care provider will discuss these with you.
Koita J, Riggio S, Jagoda A. The mental status examination in emergency practice. Emerg Med Clin N Am. 2010;28:439-451.
Snyderman D, Rovner B. Mental status exam in primary care: a review. Am Fam Physician. 2009;80:809-814.
Christos Ballas, MD, private practice specializing in psychiatry, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.