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6 - Mental status examination

Published online by Cambridge University Press:  31 July 2009

Bruce L. Miller
Affiliation:
University of California, San Francisco
Bradley F. Boeve
Affiliation:
Mayo Foundation, Minnesota
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Summary

Introduction

One of the challenges facing behaviorally oriented neurologists is that many patients' symptoms fall beyond the scope of a physical neurological evaluation. Frequently, patients with neurodegenerative disease, particularly in the early stages, present with intact cranial nerves, reflexes, eye movements, and sensory-motor function. Accordingly, clinicians need tools to formally assess the cognitive, psychiatric and behavioral abnormalities that define many dementing disorders. The mental status examination is the part of the neurological examination that assesses current mental capacity through evaluation of appearance, mood, perceptions (e.g. delusions, hallucinations) and all aspects of cognition (e.g. attention, orientation, memory).

According to Frey (2002), a comprehensive mental status examination evaluates 10 areas of functioning: (1) overall appearance, (2) movement and behavior (gait, coordination, eye contact and facial expressions), (3) mood (underlying emotional tone of person's answers), (4) affect (outwardly observable emotional reactions), (5) speech (volume, rate, tone, appropriateness and clarity), (6) thought content (hallucinations, delusions, obsessions, dissociative symptoms and thoughts of suicide), (7) thought process (repeated words or phrases, thought blocking, illogical connections), (8) cognition, (9) judgement (what to do about a common sense problem) and (10) insight (ability to recognize a problem and understand its nature and severity). This chapter will describe some widely used approaches for assessing mental status, with a particular emphasis on the cognitive changes typically seen in neurodegenerative disease.

Several standardized mental status examinations exist that enable quantification of cognitive impairment, typically yielding a single composite score that reflects disease severity.

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Publisher: Cambridge University Press
Print publication year: 2009

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References

Ala, T. A., Hughes, L. F., Kyrouac, G. A., Ghobrial, M. W., and Elble, R. J. (2001). Pentagon copying is more impaired in dementia with Lewy bodies than in Alzheimer's disease. Journal of Neurology, Neurosurgery, and Psychiatry, 72, 129–130.Google Scholar
Ala, T. A., Hughes, L. F., Kyrouac, G. A., Ghobrial, M. W., and Elble, R. J. (2002). The mini-mental state exam may help in the differentiation of dementia with Lewy bodies and Alzheimer's disease. International Journal of Geriatric Psychiatry, 17, 503–509.CrossRefGoogle ScholarPubMed
Albers, D. S., Augood, S. J., Park, L. C. H.et al. (2000). Frontal lobe dysfunction in progressive supranuclear palsy. Journal of Neurochemistry, 74, 878–881.CrossRefGoogle ScholarPubMed
Albert, M. L., Feldman, R. G., and Willis, A. L. (1974). The “subcortical dementia” of progressive supranuclear palsy. Journal of Neurology, Neurosugery, and Psychiatry, 37, 121–130.CrossRefGoogle ScholarPubMed
Anderson, C. V., Bigler, E. D. and Blatter, D. D. (1995). Frontal lobe lesions, diffuse damage, and neuropsychological functioning in traumatic brain-injured patients. Journal of Clinical and Experimental Neuropsychology, 17, 900–908.CrossRefGoogle ScholarPubMed
Baddeley, A. D. (1995). The psychology of memory. In Baddeley, A. D., Wilson, B. A. and Watts, F. N. (eds.), Handbook of Memory Disorder. Cambridge, UK: John Wiley, pp. 3–25.Google Scholar
Bak, T. H., Crawford, L. M., Hearn, V. C., Mathuranath, P. S., and Hodges, J. R. (2005). Subcortical dementia revisited: similarities and differences in cognitive function between progressive supranuclear palsy (PSP), corticobasal degeneration (CBD) and multiple system atrophy (MSA). Neurocase, 11, 268–273.CrossRefGoogle Scholar
Baker, S., Roger, R., Owen, A.et al. (1996). Neural systems engaged by planning: a PET study of the Tower of London Task. Neuropsychologia, 34, 515–526.CrossRefGoogle ScholarPubMed
Barkley, R. A. (2000). Genetics of childhood disorders. Journal of the American Academy of Child Adolescent Psychiatry, 39, 1064–1070.CrossRefGoogle ScholarPubMed
Bell-McGinty, S., Podell, K., Franzen, M.et al. (2002). Standard measures of executive function in predicting instrumental activities of daily living in older adults. International Journal of Geriatric Psychiatry, 17, 828–834.CrossRefGoogle ScholarPubMed
Benton, A. L. and Hamsher, K. S. (1989). Multilingual Aphasia Examination. Iowa City, IA: AJA Associates.Google Scholar
Benton, A. L., Hannay, H. J., and Varney, N. R. (1975). Visual perception of line direction in patients with unilateral brain disease. Neurology, 25:907–910. [Reprinted in Costa, L. and Spreen, O. (eds.) (1985). Studies in Neuropsychology. Selected Papers of Arthur Benton. New York: Oxford University Press.]
Berg, R. A., Franzen, M., and Wedding, D. (1994). Screening for Brain Impairment: A Manual for Mental Health Practice, 2nd edn. New York: Springer.Google Scholar
Boyle, P. A., Malloy, P. F., Salloway, S.et al. (2003). Executive dysfunction and apathy predict functional impairment in Alzheimer's disease. American Journal of Geriatric Psychiatry, 11, 214–221.CrossRefGoogle Scholar
Bradshaw, J., Saling, M., Hopwood, M., Anderson, V., and Brodtmann, A. (2004). Fluctuating cognition in dementia with Lewy bodies and Alzheimer's disease is qualitatively distinct. Journal of Neurology, Neurosurgery, and Psychiatry, 75, 382–387.CrossRefGoogle ScholarPubMed
Brandt, J., Folstein, S. E., and Folstein, M. F. (1988). Differential cognitive impairments in Alzheimer's disease and Huntington's disease. Annals of Neurology, 23, 555–561.CrossRefGoogle Scholar
Cahn-Weiner, D. A., Malloy, P. F., Boyle, P. A., Marran, M., and Salloway, S. (2000). Prediction of functional status from neuropsychological tests in community-dwelling elderly individuals. Clinical Neuropsychology, 14, 187–195.CrossRefGoogle ScholarPubMed
Cahn-Weiner, D. A., Boyle, P. A., and Malloy, P. F. (2002). Tests of executive function predict instrumental activities of daily living in community-dwelling older individuals. Applications of Neuropsychology, 9, 187–191.CrossRefGoogle ScholarPubMed
Cahn-Weiner, D. A., Ready, R. E., and Malloy, P. F. (2003). Neuropsychological predictors of everyday memory and everyday functioning in patients with mild Alzheimer's disease. Journal of Geriatric Psychiatry and Neurology, 16, 84–89.CrossRefGoogle ScholarPubMed
Copeland, J. R., Kelleher, M. J., Kellett, J. M.et al. (1976). A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly: the Geriatric Mental State Schedule. I. Development and reliability. Psychological Medicine, 6, 439–449.CrossRefGoogle Scholar
Crum, R. M., Anthony, J. C., Bassett, S. S., and Folstein, M. F. (1993). Population-based norms for the Mini-Mental State Examination by age and educational level. Journal of the American Medical Association, 269, 2386–2391.CrossRefGoogle ScholarPubMed
Cullum, C. M., Thompson, L. L., and Smernoff, E. N. (1993). Three-word recall as a measure of memory. Journal of Clinical and Experimental Neuropsychology, 15, 321–329.CrossRefGoogle Scholar
Cummings, J. L., Mega, M., Gray, K.et al. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.CrossRefGoogle ScholarPubMed
Delis, D. C., Kramer, J. H., Kaplan, E., and Ober, B. A. (2000). California Verbal Learning Test-Second Edition (CVLT-II). San Antonio, TX: Psychological Corporation.Google Scholar
Delis, D., Kaplan, E., and Kramer, J. (2001). Delis–Kaplan Executive Function Scale. San Antonio, TX: Psychological Corporation.Google Scholar
Diehl, J., Monsch, A. U., Aebi, C.et al. (2005). Frontotemporal dementia, semantic dementia, and Alzheimer's disease: the contribution of standard neuropsychological tests to differentiate diagnosis. Journal of Geriatric Psychiatry and Neurology, 18, 39–44.CrossRefGoogle Scholar
Diehl-Schmid, J., Grimmer, T., Drzezga, A.et al. (2006). Longitudinal changes of cerebral glucose metabolism in semantic dementia. Dementia and Geriatric Cognitive Disorders, 22, 346–351.CrossRefGoogle ScholarPubMed
Eslinger, P. J. and Benton, A. L. (1983). Visuoperceptual performances in aging and dementia: clinical and theoretical implications. Journal of Clinical Neuropsychology, 5, 213–220.CrossRefGoogle ScholarPubMed
Farias, S. T., Harrell, E., Neumann, C., and Houtz, A. (2003). The relationship between neuropsychological performance and daily functioning in individuals with Alzheimer's disease: ecological validity of neuropsychological tests. Archives of Clinical Neuropsychology, 18, 655–672.CrossRefGoogle ScholarPubMed
Ferman, T. J., Smith, G. E., Boeve, B. F.et al. (2004). DLB fluctuations: specific features that reliably differentiate DLB from AD and normal aging. Neurology, 62, 181–187.CrossRefGoogle ScholarPubMed
Fields, R. (1998). The dementias. In Snyder, P. J. and Nussbaum, P. D. (eds.), Clinical Neuropsychology. Washington, DC: American Psychological Association, pp. 211–242.Google Scholar
Folstein, M.Folstein, S., and McHugh, P. (1975). Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Frey, R. J. (2002). Mental status examination. In Olendorf, D., Jervan, C., and Boyden, K. (eds.), The Gale Encyclopedia of Medicine. New York: Thomson Gale.Google Scholar
Greenlief, C. L., Margolis, R. B., and Erker, G. J. (1985). Application of the Trail Making Test in differentiating neuropsychological impairment of elderly persons. Perceptual and Motor Skills, 61, 1283–1289.CrossRefGoogle ScholarPubMed
Hodges, J. and Miller, B. (2001). The neuropsychology of frontal variant frontotemporal dementia and semantic dementia. Introduction to the special topic papers: part II. Neurocase, 7, 113–121.CrossRefGoogle ScholarPubMed
Hodges, J., Patterson, K., Ward, R.et al. (1999). The differentiation of semantic dementia and frontal lobe dementia (temporal and frontal variance of frontotemporal dementia) from early Alzheimer's disease: a comparative neuropsychological study. Neuropsychology, 13, 31–40.CrossRefGoogle Scholar
Hughes, C. P., Berg, L., Danziger, W. L., Coben, L. A., and Martin, R. L. (1982). A new clinical scale for the staging of dementia. British Journal of Psychiatry, 140, 566–572.CrossRefGoogle Scholar
Jefferson, A. L., Cosentino, S. A., Ball, S. K.et al. (2002). Errors produced on the mini-mental state examination and neuropsychological test performance in Alzheimer's disease, ischemic vascular dementia, and Parkinson's disease. Journal of Neuropsychiatry and Clinical Neuroscience, 14, 311–320.CrossRefGoogle ScholarPubMed
Jefferson, A. L., Paul, R. H., Ozonoff, A. and Cohen, R. A. (2006). Evaluating elements of executive functioning as predictors of instrumental activities of daily living (IADLs). Archives of Clinical Neuropsychology, 21, 311–320.CrossRefGoogle Scholar
Johnson, D. K., Morris, J. C., and Galvin, J. E. (2005a). Verbal and visuospatial deficits in dementia with Lewy bodies. Neurology, 65, 1232–1238.CrossRefGoogle ScholarPubMed
Johnson, J. K., Diehl, J. M., Neuhaus, J.et al. (2005b). Frontotemporal lobar degeneration demographic characteristics of 353 patients. Archives of Neurology, 62, 925–930.CrossRefGoogle ScholarPubMed
Kaplan, E. F., Goodglass, H., and Weintraub, S. (1983). The Boston Naming Test, 2nd edn. Philadelphia, PA: Lea and Febiger.Google Scholar
Kiernan, R. J., Mueller, J., Langston, J. W., and Dyke, C. (1987). The Neurobehavioral Cognitive Status Examination: a brief but quantitative approach to cognitive assessment. Annuls of International Medicine, 107, 481–485.CrossRefGoogle ScholarPubMed
Kramer, J. H. and Quitania, L. (2007). Bedside frontal lobe testing. In Miller, B. L. and Cummings, J. L. (eds.), The Human Frontal Lobes: Functions and Disorders, 2nd edn. New York: The Guilford Press, pp. 279–291.Google Scholar
Kramer, J. H., Jurik, J., Sha, S. J.et al. (2003). Distinctive neuropsychological patterns in frontotemporal dementia, semantic dementia, and alzheimer disease. Cognitive and Behavioral Neurology, 16, 211–218.CrossRefGoogle ScholarPubMed
Kramer, J. H., Schuff, N., Reed, B. R.et al. (2004). Hippocampal volume and retention in Alzheimer's disease. Journal of the International Neuropsychological Society, 10, 639–643.CrossRefGoogle ScholarPubMed
Kraybill, M. L., Larson, E. B., Tsuang, D. W.et al. (2005). Cognitive differences in dementia patients with autopsy-verified AD, Lewy body pathology, or both. Neurology, 64, 2069–2073.CrossRefGoogle Scholar
Lezak, M., Howieson, D., and Loring, D. (2004). Neuropsychological Assessment, 4th edn. New York: Oxford University Press.Google Scholar
Libon, D. J., Xie, S. X., Moore, P.et al. (2007). Patterns of neuropsychological impairment in frontotemporal dementia. Neurology, 68, 369–375.CrossRefGoogle ScholarPubMed
Luis, C. A., Mittenberg, W., Gass, C. S., and Durara, R. (1999). Diffuse Lewy body disease: clinical, pathological, and neuropsychological review. Neuropsychology Review, 9, 137–150.CrossRefGoogle ScholarPubMed
Massman, P. J., Delis, D. C., Butters, N., Levin, B. E., and Salmon, D. P. (1990). Are all subcortical dementias alike? Verbal learning and memory in Parkinson's and Huntington's disease patients. Journal of Clinical and Experimental Neuropsychology, 12, 729–744.CrossRefGoogle ScholarPubMed
Mathuranath, P. S., Neston, P. J., Berrios, G. E., Rakowicz, W., and Hodges, J. R. (2000). A brief cognitive test battery to differentiate Alzheimer's disease and frontotemporal dementia. American Academy of Neurology, 55, 1613–1620.CrossRefGoogle ScholarPubMed
McKeith, I. G., Galasko, D., Kosaka, K.et al. (1996). Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the Consortium of DLB International Workshop. Neurology, 47, 1113–1124.CrossRefGoogle Scholar
McKeith, I. G., Dickson, D. W., Lowe, J.et al. (2005). Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology, 65, 1863–1872.CrossRefGoogle ScholarPubMed
McMillan, C., Gee, J., Moore, P.et al. (2004). Confrontation naming and morphometric analyses of structural MRI in frontotemporal dementia. Dementia and Geriatric Cognitive Disorders, 17, 320–323.CrossRefGoogle ScholarPubMed
Millar, D., Griffiths, P., Zermansky, A. J., and Burn, D. J. (2006). Characterizing behavioral and cognitive dysexecutive changes in progressive supranuclear palsy. Movement Disorders, 21, 199–207.CrossRefGoogle ScholarPubMed
Miller, B. L., Seeley, W. W., Mychack, P.et al. (2001). Neuroanatomy of the self: evidence from patients with frontotemporal dementia. Neurology, 57, 817–821.CrossRefGoogle ScholarPubMed
Mitrushina, M. and Satz, P. (1991). Reliability and validity of the Mini-Mental State Exam in neurologically intact elderly. Journal of Clinical Psychology, 47, 537–543.3.0.CO;2-9>CrossRefGoogle ScholarPubMed
Mori, E., Shimomura, T., Fujimori, M.et al. (2000). Visuoperceptual impairment in dementia with Lewy bodies. Archives of Neurology, 57, 489–493.CrossRefGoogle ScholarPubMed
Mungas, D., Reed, B. R., and Kramer, J. H. (2003). Psychometrically matched measures of global cognition, memory and executive function for assessment of cognitive decline in older persons. Neuropsychology, 17, 380–392.CrossRefGoogle ScholarPubMed
Neary, D., Snowden, J. S., Gustafson, L.et al. (1999). Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology, 51, 1546–1554,CrossRefGoogle Scholar
Osterrieth, P. A. (1944). Le test de copie d'une figure complexe. Archives de Psychologie, 30, 206–356 [Trans. Corwin, J. and Bylsma, F. W. (1993) The Clinical Neuropsychologist, 7, 9–15].
Perry, R. and Hodges, J. (2000). Differentiating frontal and temporal variant frontotemporal dementia from Alzheimer's disease. Neurology, 54, 2277–2284.CrossRefGoogle ScholarPubMed
Pfeffer, R. I., Kurosaki, T. T., Harrah, C. H., Chance, J. M., and Filos, S. (1982). Measurement of functional activities in older adults in the community. Journal of Gerontology, 37, 323–329.CrossRefGoogle Scholar
Pfeiffer, E. (1975). A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. Journal of the American Geriatric Society, 23, 433–441.CrossRefGoogle Scholar
Rascovsky, K., Salmon, D. P., Hansen, L. A., Thal, L. J., and Galasko, D. (2007). Disparate letter and semantic category fluency deficits in autopsy-confirmed frontotemporal dementia and Alzheimer's disease. Neuropsychology, 21, 20–30.CrossRefGoogle ScholarPubMed
Reitan, R. M., and Wolfson, D. (1985). The Halstead–Reitan Neuropsychological Test Battery. Tucson, AZ: Neuropsychological Press.Google Scholar
Rey, A. (1941). L'examen psychologique dans les cas d' encephalopathie traumatique. Archives de Psychologie, 28, 21.Google Scholar
Rosen, H. J., Gorno-Tempini, M. L., Goldman, W. P.et al. (2002). Patterns of brain atrophy in frontotemporal dementia and semantic dementia. Neurology, 22, 198–208.CrossRefGoogle Scholar
Ruff, R. M., Light, R. H., and Evans, R. W. (1987). The Ruff Figural Fluency Test: a normative study with adults. Developmental Neuropsychology, 3, 37–52.CrossRefGoogle Scholar
Solomon, P. R., Hirschoff, A., Kelly, B.et al. (1998). A 7 minute neurocognitive screening battery highly sensitive to Alzheimer's disease. Archives of Neurology, 55, 349–355.CrossRefGoogle ScholarPubMed
Squire, L. R. and Butters, N. (eds.) (1984). Neuropsychology of Memory. New York: The Guilford Press.CrossRefGoogle Scholar
Stroop, J. R. (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology, 18, 643–662.CrossRefGoogle Scholar
Strub, R. L. and Black, F. W. (2000). The Mental Status Examination in Neurology, 4th edn. Philadelphia, PA: F. A. Davis.Google Scholar
Sunderland, A., Watts, K., Baddeley, A. D., and Harris, J. E. (1986). Subjective memory assessment and test performance in elderly adults. Journal of Gerontology, 41, 376–384.CrossRefGoogle ScholarPubMed
Tekin, S., and Cummings., J. L. (2002). Frontal–subcortical neuronal circuits and clinical neuropsychiatry: an update. Journal of Psychosomatic Research, 53, 647–654.CrossRefGoogle ScholarPubMed
Teng, E. L. and Chiu, H. C. (1987). The modified mini-mental state (3MS) examination. Journal of Clinical Psychiatry, 48, 314–318.Google ScholarPubMed
Teng, E. L., Hasegawa, K., Homma, A.et al. (1994). The Cognitive Abilities Screening Instrument (CASI): a practical test for cross-cultural epidemiological studies of dementia. International Psychogeriatrics, 6, 45–58.CrossRefGoogle Scholar
Terry, R. D., and Katzman, R. (1983). Senile dementia of the Alzheimer type. Annals of Neurology, 14, 497–506.CrossRefGoogle ScholarPubMed
Thompson, J. C., Stopford, C. L., Snowden, J. S., and Neary, D. (2005). Qualitative neuropsychological performance characteristics in frontotemporal dementia and Alzheimer's disease. Journal of Neurology, Neurosurgery and Psychiatry, 76, 920–927.CrossRefGoogle ScholarPubMed
Troyer, A. K. (2000). Normative data for clustering and switching on verbal fluency tasks. Journal of Clinical and Experimental Neuropsychology, 22, 29–39.CrossRefGoogle ScholarPubMed
Walker, R., Husain, M., Hodgson, T. L., Harrison, J., Kennard, C. (1998). Saccadic eye movement and working memory deficits following damage to human prefrontal cortex. Neuropsychologia, 36, 1141–1159.CrossRefGoogle ScholarPubMed
Walker, Z., Allen, R. L., Shergill, S., and Katona, C. L. E. (1997). Neuropsychological performance in Lewy body dementia and Alzheimer's disease. British Journal of Psychiatry, 170, 156–158.CrossRefGoogle ScholarPubMed
Warrington, E. K. and James, M. (1991). Visual Object and Space Perception Battery. Bury St. Edmunds, UK: Thames Valley Test.Google Scholar
Wechsler, D. (1997). Wechsler Adult Intelligence Scale, 3rd edn, (WAIS-III) Administration and Scoring Manual. San Antonio, TX: The Psychological Corporation.Google Scholar
Wicklund, A. H., Johnson, H., Rademaker, A., Weitner, B. B., and Weintraub, S. (2006). Word list versus story memory in Alzheimer disease and frontotemporal dementia. Alzheimer Disease and Associated Disorders, 20, 86–92.CrossRefGoogle ScholarPubMed
Wilson, B. A. (1991). Long-term prognosis of patients with severe memory disorder. Neuropsychological Rehabilitation, 1, 117–134.CrossRefGoogle Scholar
Wilson, B. A., Cockburn, J., and Baddeley, A. (1985). The Rivermead Behavioural Memory Test. Bury St. Edmunds, UK: Thames Valley Test.Google Scholar
Wilson, B. A., Cockburn, J., Baddeley, A. D., and Hiorns, R. (1989). The development and validation of a test battery for detecting and monitoring everyday memory problems. Journal of Clinical and Experimental Neuropsychology, 11, 855–870.CrossRefGoogle ScholarPubMed
Wilson, R. S., Gilley, D. W., Bennett, D. A., Beckett, L. A., and Evans, D. A. (2000). Person-specific paths of cognitive decline in Alzheimer's disease and their relation to age. Psychology and Aging, 15, 18–28.CrossRefGoogle Scholar
Yesavage, J. A., Brink, T. L., Rose, T. L.et al. (1983). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 37–49.CrossRefGoogle Scholar

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