Family story of memory loss - Information from a family member describing that a patient has lost memory function or experienced a change in mental status is often a rapid and sensitive method of identifying an organic syndrome. Additionally, a history of memory decline or changes in mental status obtained from a family member will often be more reliable than a history obtained from the patient with suspected changes in mental status. For example, a patient with a true dementia will typically deny that there is a problem.

Orientation - Assess orientation to precise time (i.e., month, day, and year). Obviously, atypical or incorrect responses likely signify a change in mental status.

General information - Ask the patient to identify general information questions, such as current events or “Who are the president and vice president of the United States?” Obviously, atypical or incorrect responses likely signify a change in mental status.

Spelling - Ask the patient to spell a simple word forwards and backwards, or use numbers if the patient cannot spell. The ability to spell forward but not backwards may indicate an organic disorder.