The SLUMS Alzheimer's Screening Test

Saint Louis University Mental Status Examination

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SLUMS, the Saint Louis University Mental Status Examination, is a screening test for Alzheimer's disease and other kinds of dementia. It is an alternative to the widely used Mini-Mental State Examination (MMSE).

SLUMS was designed to be more effective at identifying people with very early Alzheimer's symptoms, also called mild cognitive impairment (MCI) or mild neurocognitive disorder (MNCD). These symptoms occur as people progress from normal aging to early Alzheimer's disease.

Doctor in discussion with mature female patient
Thomas Barwick / Getty Images

What Does SLUMS Assess?

SLUMS measures aspects of cognition. It consists of 11 questions that help a healthcare provider evaluate:

For example, the administrator will ask the test taker to:

  • Tell them what year and day of the week it is
  • Memorize a list of five objects and repeat them back a few minutes later
  • Name as many animals as they can in a minute
  • Draw the numbers on a blank clock face and mark a specific time
  • Indicate which shape in a set of three is the largest

You can view the full SLUMS assessment on St. Louis University's website.

The SLUMS test takes approximately seven minutes to administer.

SLUMS Scoring and Results

Depending on the question, answers count for between 0 and 5 points. Final scores range from 0 to 30.

SLUMS scores are interpreted as follows:

  • 27 to 30: Normal in a person with a high school education
  • 21 to 26: Suggest a mild neurocognitive disorder
  • 0 to 20: Indicate dementia

Despite its value as a screening tool, the SLUMS should never be considered a substitute for a full diagnostic workup for Alzheimer's disease or be administered by anyone other than a trained medical professional.

How Accurate Is SLUMS?

SLUMS is thought to be more sensitive than the MMSE, another assessment of cognitive function. That means that it can more reliably determine who is in various levels of cognitive decline.

In a 2012 study, Saint Louis University researchers used both the SLUMS and the MMSE to test 533 men who were at least 60 years old and treated at the Geriatric Research Education Clinical Center, Veterans Administration Hospitals in St. Louis.

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, as well as the Short Test of Mental State (STMS) and the Test Your Memory (TYM) screen—other cognition assessments.

They 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.

Advantages and Disadvantages of SLUMS

Though it has notable pluses, the SLUMS test also has some cons that need to be considered.

Pros
  • Better than MMSE at identifying milder cognitive problems that don't yet rise to the level of dementia

  • Free to use; other tests require a fee

Cons
  • Not as widely used as MMSE

  • Less researched for reliability and validity 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.

Frequently Asked Questions

  • Who should administer the SLUMS test?

    The test should be given by a doctor or other qualified medical professional. Even though the test can be downloaded for free for anyone to use, a medical professional can help put the results in perspective and determine if any further tests are needed.

  • What are the stages of dementia?

    There are seven stages of dementia. They range from stage 1 (no noticeable symptoms) to stage seven (severe impairment of function), with the stages in between representing increasing levels of cognitive decline.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Howland M, Tatsuoka C, Smyth KA, Sajatovic M. Detecting change over time: a comparison of the SLUMS examination and the MMSE in older adults at risk for cognitive decline. CNS Neurosci Ther. 2016;22(5):413-9. doi:10.1111/cns.12515

  2. St. Louis University Medical School. VA SLUMS exam.

  3. Cruz-oliver DM, Malmstrom TK, Allen CM, Tumosa N, Morley JE. The Veterans Affairs Saint Louis University mental status exam (SLUMS exam) and the Mini-mental status exam as predictors of mortality and institutionalization. J Nutr Health Aging. 2012;16(7):636-41. doi:10.1007/s12603-012-0098-9

  4. Szcześniak D, Rymaszewska J. The usfulness of the SLUMS test for diagnosis of mild cognitive impairment and dementia. Psychiatr Pol. 2016;50(2):457-72. doi:10.12740/PP/OnlineFirst/43141.

Additional Reading

By Andrew Rosenzweig, MD
Andrew Rosenzweig, MD, MPH, is an Alzheimer's disease expert and the chief clinical officer for MedOptions.