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Section 5. Delirium and Dementia
Chapter 38. Mental Status Examination
Topics:    Introduction |  Clinical Assessment |  Quantitative Assessment

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Introduction

Part of the physical examination that assesses current mental capacity through evaluation of appearance, mood, anxiety disorders, perceptions (eg, delusions, hallucinations), and all aspects of cognition (eg, attention, orientation, memory).

Problems with mental status can be suggested by the medical history (by both its content and its manner of delivery by the patient); however, determination and documentation of current mental status require a mental status examination. Identification of the underlying cause of abnormal mental status requires integrating all information from the history, the mental status examination, other components of the physical examination, and laboratory tests.

Mental status examination begins with the clinical assessment of the patient and is followed by use of one or more quantitative assessment instruments (see Table 38-1), the most widely used being the Mini-Mental State Examination. Quantitative assessment instruments can be used in screening for cognitive and related disorders and in assessing response to treatment. Serial quantitative measurements of cognition should be considered for any elderly patient suspected of experiencing delirium or progressive changes in cognition.

Mental status examinations can help a court establish a person's legal competence for making a will or for giving informed consent for procedures. When combined with functional assessment, these examinations help the physician select an appropriate environment and level of care for a patient after hospital discharge.

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