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Neurocognitive testing - Overview

Alternative Names

Mental status exam; Mental status tests

Definition of Neurocognitive testing:

Neurocognitive testing is used to find out about a person's thinking abilities, and to determine whether these problems are improving or getting worse.

How the test is performed:

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:

APPEARANCE

The health care provider will check the person's physical appearance, including:

  • Age
  • Dress
  • General level of comfort
  • Gender
  • Grooming
  • Height/weight

ORIENTATION

The health care provider will ask questions that may include:

  • The person's name, age, and job
  • The place where the person lives, type of building, city, and state, or the hospital or facility they are currently in
  • The time, date, and season

ATTENTION SPAN

Attention span may be tested earlier, because this fundamental skill can influence the rest of the tests.

The provider will want to test:

  • The person's ability to complete a thought
  • The person's ability to think and problem solve
  • Whether the person is easily distracted

A person may be asked to do the following:

  • Start at a certain number, and then begin to subtract backwards by 7s.
  • Spell a word such as "WORLD" forward, and then backward.
  • Repeat up to 7 numbers foward, 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 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.

LANGUAGE FUNCTION

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.

JUDGMENT

To test the person's judgment and ability to solve a problem or situation, the provider might ask questions such as:

  • "If you found a driver's license on the ground, what would you do?"
  • "If a police officer approached you from behind in a car with lights flashing, what would you do?"

How to prepare for the test:

No preparation is necessary for these tests.

How the test will feel:

There is no physical discomfort. Some people might find it stressful to answer all of the questions. Difficulties answering could lead to frustration.

  • Reviewed last on: 3/9/2010
  • Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Snyderman D, Rovner B. Mental status exam in primary care: a review. Am Fam Physician. 2009;80:809-814.

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