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Remote memory

RFeb 02 05

Alternative names 
Mental status tests; Recent memory; Word comprehension; Orientation; Attention span; Cognitive tests

Definition
Mental status tests are used to objectively assess mental function.

How the test is performed
Orientation:
Your health care provider will ask you all or some of the following questions:

     
  • The time, date, and season  
  • The place where you live, type of building you are in, city and state you are in  
  • Your name, age, and occupation

Attention span:
Your health care provider will test your ability to complete a thought. This may be evident through conversation or you may be asked to follow a series of directions in order to base conclusions on your performance.

Recent memory:
This is the memory of people, places, and events that have recently been involved in your life. Your health care provider can easily test your remote memory by asking you questions related to recent events in your life or the world around you.

Remote memory:
This is the memory of people, places, and events that occurred earlier in your life. Your health care provider can test your remote memory by asking about your childhood, school, or historical events that occurred earlier in your life.

Word comprehension:
This tests your knowledge of common items. Your health care provider will point to every day items in the room and have you name them.

Judgment:
This test measures your judgment and ability to exercise alternative solutions to a given problem or situation. For example, your health care provider might ask, “What would you do if a police officer approached from behind in a car with lights flashing?” or “If you found a drivers’ license on the ground, what would you do?”

How to prepare for the test
No preparation is necessary for this test. All responses should be natural, spontaneous, and honest. Preparation, especially by a highly intelligent person, could distort the results of the test by making it appear that cognitive function has not diminished when, in fact, it actually has.

How the test will feel
There is no physical discomfort.

Why the test is performed
These tests are screening tools for cognitive impairment, and supply your health care provider with an objective measure of improvement or deterioration.

Normal Values

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

What abnormal results mean
Orientation:
Typically, orientation is first lost to time, then place, then 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 (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:
If you are unable to complete a thought, or are easily distracted by other stimuli, you may have an abnormal attention span. This may have a number of causes. A few examples are:

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

Recent and Remote Memory:
Organic syndromes are indicated if there is a loss of recent memory, but remote memory remains intact. Remote memory is lost when there is damage to the upper part of the brain as occurs in 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:
We exercise judgment in all of our daily activities, and 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

What the risks are

There are no risks associated with cognitive tests.

Special considerations

Some tests that screen for aphasia (problems with language due to brain dysfunction), such as those involving reading or writing, do not account for people that may never have been able to read or write. If you know that the person to be tested has never been able to read or write, notify 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.

Johns Hopkins patient information

Last revised: December 5, 2007
by David A. Scott, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.
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