Neurocognitive testing is used to find out about a person's thinking abilities, and to determine whether these problems are improving or getting worse.
Mental status exam; Mental status tests
A nurse, physician, physician assistant, or mental health worker will ask a number of questions. The test can be performed in the home, in an office, nursing home, or hospital. Occasionally, a psychologist with special training will do more extensive tests.
Most of the time, the provider will use neurocognitive tests that are also used by many other providers, which gives a score at the end. The most common test used is called the mini-mental state examination (MMSE) or Folstein test.
The following areas may be tested:
The health care provider will check the person's physical appearance, including:
The health care provider will ask questions that may include:
Attention span may be tested earlier, because this fundamental skill can influence the rest of the tests.
The provider will want to test:
A person may be asked to do the following:
RECENT AND PAST MEMORY
The provider will ask questions related to recent people, places, and events in the person's 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 the person's childhood, school, or events that occurred earlier in life.
The provider will point to everyday items in the room and ask the person to name them, and possibly to name less common items.
The person may be asked to follow a 1-step, 2-step, and 3-step instruction.
The provider may ask the person to say as many words as possible that start with a certain letter, or that are part of a certain category, in 1 minute.
The person may be asked to read or write a sentence.
To test the person's judgment and ability to solve a problem or situation, the provider might ask questions such as:
No preparation is necessary for these tests.
There is no physical discomfort. Some people might find it stressful to answer all of the questions. Difficulties answering could lead to frustration.
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.
A number of conditions or problems can affect mental status:
See the following for a complete list of causes and treatments:
There are no risks with these tests.
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.
Snyderman D, Rovner B. Mental status exam in primary care: a review. Am Fam Physician. 2009;80:809-814.