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.
How the Test is Performed
A health care provider 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.
Common tests used are the:
- Mini-mental state examination (MMSE) or Folstein test
- Montréal cognitive assessment (MoCA)
Mental status testing looks at the following factors:
The provider will check your physical appearance, including:
- General level of comfort
- Eye contact
- Friendly or hostile
- Cooperative or ambivalent (uncertain)
The 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?
- Are you calm or irritable and anxious
- Do you have a normal expression and body movement (affect) or display a flat and depressed affect
Attention span may be tested earlier, because this basic 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 3 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 determine if you can express your ideas clearly. The provider will note if you repeat yourself or repeat what the provider says. The provider will also find out if you have trouble expressing or understanding (aphasia).
The provider will point to everyday items in the room and ask you to name them. Or you may be asked to name less common items.
You may be asked to say as many words as possible in one minute that:
- Start with a certain letter
- Are in a certain category
You may be asked to read or write a sentence.
JUDGMENT AND INTELLIGENCE
This part of the test looks at how well you solve a problem or situation. You may be asked questions such as:
- "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 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 provider before the test.
If your child is having the test, it is important to help them understand the reason for the test.
Most tests are divided into sections, each with its own score. The 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 mental status. The provider will discuss these with you. An abnormal mental status test alone does not diagnose the cause. However, doing poorly on such tests can be due to medical illness, brain disease such as dementia, Parkinson disease, or to mental illness. Even when the cause is known, tests may be repeated over time to see if treatment is working.
Mental status exam; Neurocognitive testing; Dementia-mental status testing
Beresin EV, Gordon C. The psychiatric interview. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 2.
Paulsen JS, Gehl C. Neuropsychology. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley's and Daroff’s Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 44.
Review Date 11/9/2021
Updated by: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.