What is a Mental Status Exam?

A mental status exam is a standard test given by neurologists, psychologists, and neuropsychologists to measure cognitive functioning in an individual. In some clinics, these are standardly given to all incoming clients; whereas in other clinics they are only administered to patients with potential neurological disease.  Neurologists are trained to perform a mental status exam on all incoming patients as a way of screening for subtle or non-apparent cognitive dysfunction. In addition, many neurological disorders of old age (such as Alzheimer’s Disease) can be difficult to diagnose in the early stages. For this reason, some clinicians prefer to do multiple standardized cognitive tests (such as the mini mental status exam) over time to measure a change in functioning over time, to see if there is a steady decrease in functioning.

Numerous factors affect an individual’s performance on a mental status exam. These factors include non-disease variables, such as age, level of education, cultural background, employment history, and language spoken as compared to the language in which the test is administered.

Although there are a few different  standard mental status exam, almost all contain variations on the same elements tested. These  include:

1.       Assessment of attention and concentration

2.       Determination of a patient’s digit span

3.       Temporal and spatial orientation (awareness of place and time)

4.       Understanding and communicating speech

5.       Registration, storage, and recall of new memories; often given in the form of word lists

6.       Specific cognitive skills

a.       Mathematical calculation

b.      Spelling forwards and backwards

c.       Orientation of body parts in space

d.      Visual-constructive ability

e.      Word generation

f.        Serial motor sequences

g.       Shifting performance on tasks with altered instructions

h.      Interpretation of abstract statements

Scores on standardized neuropsychological tests, such as the mental status exam, are based on averages gathered from the population, in both healthy and diseased populations. What this means is that, if you have Alzheimer’s Disease, than your scores would be compared to the average scores of both healthy and diseased individuals of your same age and education level. From this, it can be determined whether you are still performing at the expected level of your peers.

In addition, since mental status examinations are usually very brief, they are often used as a screener. So if you performed quite poorly in one area, further testing specific to that area of concern will be warranted.  Mental status examinations are not meant to be diagnostic in and of themselves, they are meant to be taken as part of a series of clinical data.. included with neurological history, MRI or CT examination results, symptoms, family history, and all other relevant data offered by the patient.