Physical examination maneuver
Physical Exam
Mental Status Assessment
🎬
Video coming September 2026
How to Perform
Through conversation and targeted tasks, assess the domains of the mental status examination: level of consciousness and arousal; appearance and behavior; attention (for example, digit span); orientation to person, place, and time; memory (immediate, recent, and remote); language (fluency, naming, repetition, comprehension); and higher cognitive functions (calculation, abstraction, and judgment). Standardized instruments may be used to score cognition.
How to Interpret
Showing all 13 findings
Delirium
Confusion Assessment Method (CAM) positive
Rule in
Very helpful
Rule out
Helpful
Evidence:Strong
Confusion Assessment Method for the ICU (CAM-ICU) positive in an ICU patient
Rule in
Very helpful
Rule out
Somewhat helpful
Evidence:Strong
4 'A's Test (4AT) score greater than 3 positive
Rule in
Helpful
Rule out
Helpful
Evidence:Strong
Intensive Care Delirium Screening Checklist (ICDSC) score greater than or equal to 4 positive in an ICU patient
Rule in
Somewhat helpful
Rule out
Somewhat helpful
Evidence:Strong
Single Question in Delirium (SQID) positive
Rule in
Somewhat helpful
Rule out
Minimally helpful
Evidence:Limited
Dementia
Addenbrooke's Cognitive Examination-Revised (ACE-R) total score less than 88 positive
Rule in
Helpful
Rule out
Very helpful
Evidence:Strong
Montreal Cognitive Assessment (MoCA) score less than 26 positive
Rule in
Helpful
Rule out
Very helpful
Evidence:Strong
Mini-Cog score less than or equal to 2 (out of 5) positive in adults 60 or over
Rule in
Helpful
Rule out
Helpful
Evidence:Strong
Mini-Mental State Examination (MMSE) score less than 24 positive in adults 65 or over
Rule in
Helpful
Rule out
Helpful
Evidence:Strong
Major Depressive Disorder
Whooley 2-question screen positive
Rule in
Somewhat helpful
Rule out
Very helpful
Evidence:Strong
Patient Health Questionnaire-9 (PHQ-9) total score greater than or equal to 10 positive
Rule in
Helpful
Rule out
Helpful
Evidence:Strong
Geriatric Depression Scale 15-item short form (GDS-15) total score greater than or equal to 5 positive in older adults
Rule in
Somewhat helpful
Rule out
Helpful
Evidence:Strong
Patient Health Questionnaire-2 (PHQ-2) total score greater than or equal to 3 positive
Rule in
Somewhat helpful
Rule out
Somewhat helpful
Evidence:Strong