Mental status tests

Memory; Word comprehension; Orientation; Attention span; Cognitive tests

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

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
• Low blood sugar
• Head trauma or concussion
• Fluid and electrolyte imbalance
• Nutritional deficiencies, particularly lack of niacin, thiamine, vitamin C, or vitamin B-12
• Hyperthermia (fever)
• Hypothermia (a drop in body temperature can cause sudden confusion)
• Hypoxemia (chronic pulmonary disorders can produce persistent confusion)
• Environmental causes such as heat stroke, heavy metal poisoning, hypothermia, or methanol intoxication
• Drugs such as atropine, chloroquine, cimetidine, CNS depressants in large doses, cycloserine, oral digitalis medicines, indomethacin, lidocaine, withdrawal from narcotics and barbiturates
• Organic brain disease

ATTENTION SPAN

People who are unable to complete a thought, or are easily distracted by other stimuli, may have an abnormal attention span. This may have a number of causes, including:

• Attention deficit disorder (ADD)
• Confusion
• Manic depressive illness
• Histrionic personality disorder
• Schizophrenia

RECENT AND REMOTE MEMORY

An underlying organic medical disorder may cause loss of recent memory when remote memory remains 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 aphasia. Some causes for aphasia include:

• Head trauma
• Senile dementia (Alzheimer's type)
• Stroke
• Transient ischemic attack

JUDGMENT

The ability to determine an appropriate course of action is vital to survival in many situations. The following are some causes of impaired judgment:

• Mental retardation
• Emotional dysfunction
• Schizophrenia
• Organic brain disease