Saint Louis University Mental Status (SLUMS) Examination for Dementia

The Saint Louis University Mental Status Examination (SLUMS) is a method of screening for Alzheimer's and other kinds of dementia. It was designed as an alternative screening test to the widely used Mini-Mental State Examination (MMSE). The idea was that the MMSE is not as effective at identiyng people with very early Alzheimer's symptoms. Sometimes referred to as Mild Cognitive Impairment (MCI) or mild neurocognitive disorder (MNCD), these symptoms occur as people progress from normal aging to early Alzheimer's.

As with any Alzheimer's test, the SLUMS is a screening test and does not substitute for a full diagnostic work-up for Alzheimer's disease.

Scoring of the SLUMS

The SLUMS consists of 11 items, and measures aspects of cognition that include orientation, short-term memory, calculations, naming of animals, the clock drawing test, and recognition of geometric figures. It takes approximately seven minutes to administer.

Scores range from 0 to 30, with scores of 27-30 considered normal in a person with a high school education. Scores between 21 and 26 suggest mild neurocognitive disorder, and scores between 0 and 20 indicate dementia.

Usefulness of the SLUMS

Saint Louis University researchers used both the SLUMS and the MMSE to test 705 men who were at least 60 years old and treated at the Geriatric Research Education Clinical Center, Veterans Administration Hospitals in St. Louis in 2003. They found that while both tools detected dementia, only the SLUMS recognized a group of patients as having mild cognitive problems.

A second study involving 58 nursing home residents compared the SLUMS' ability to detect early stages of dementia to that of the MMSE, the Short Test of Mental State (STMS) and the Test Your Memory (TYM) screen. The results found that the SLUMS test was significantly better at being able to identify dementia in its early stages as compared to the other tests.

Research also found that although both the SLUMS and the MMSE have a total of 30 points, the average score of the SLUMS is approximately five points lower than that of the MMSE. This supports the idea that the SLUMS is a more difficult test and thus likely to be more sensitive to mild cognitive impairment. 

Overall Advantages and Disadvantages of the SLUMS

The advantages of the SLUMS include its superiority to the MMSE in identifying people with more mild cognitive problems that don't yet rise to the level of dementia. In addition, it is free to use, while other tests require a fee per test.

Disadvantages include the fact that the SLUMS test is not as widely used as the MMSE and it has been less researched for effectiveness than the MMSE. 

A Word from Verywell

If you visit the physician for an evaluation, the SLUMS is one of the tests that might be used to measure cognitive functioning. While it might be somewhat intimidating to undergo testing, it can also be very helpful to identify a decline in thinking or memory in its earlier stages. Benefits of early detection may include identifying possible reversible causes of memory loss, possible earlier treatment, and focusing on strategies including diet and exercise that have been shown to be helpful in slowing or reducing the chance of progression to Alzheimer's.

_Source:

Buckingham, D, Mackor, K, Miller, R, et al. Comparing the Cognitive Screening Tools: MMSE and SLUMS. Pure Insights. 2013. Vol 2, Issue 1. http://digitalcommons.wou.edu/cgi/viewcontent.cgi?article=1020&context=pure 

_{Tariq SH, Tumosa N, Chibnall JT, et al. Comparison of the Saint Louis University Mental Status Examination and the Mini-Mental State Examination for detecting dementia and mild neurocognitive disorder: a pilot study. Am J Geriatr Psychiatry. 2006;14:900-910.}

Szcześniak, D and Rymaszewska, J. Psychiatrica Polska. 2016;50(2):457-72. The usfulness of the SLUMS test for diagnosis of mild cognitive impairment and dementia. http://www.psychiatriapolska.pl/uploads/onlinefirst/ENGverSzczesniak_PsychiatrPolOnlineFirstNr18.pdf