Veterans Affairs Saint Louis University Mental Status Examination Compared with the Montreal Cognitive Assessment and the Short Test of Mental Status

Cummings‐Vaughn, Lenise A.; Chavakula, Neeraja N.; Malmstrom, Theodore K.; Tumosa, Nina; Morley, John E.; Cruz‐Oliver, Dulce M.

doi:10.1111/jgs.12874

Cited by 69 publications

(24 citation statements)

References 30 publications

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“…The sensitivity and specificity of the SLUMS exam has been validated in a VA cohort 11. As compared to the clinical dementia rating, the SLUMS exam has a sensitivity of 74% and specificity of 65% to detect mild neurocognitive disorder (MNCD) and a sensitivity of 93% and specificity of 96% to detect dementia in the VA population 12. Patient scores are interpreted in the context of the level of patient education.…”

Section: Methodsmentioning

confidence: 99%

Cognitive dysfunction and poor health literacy are common in veterans presenting with acute coronary syndrome: insights from the MEDICATION study

Marzec¹,

Carey²,

Lambert-Kerzner³

et al. 2015

PPA

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BackgroundPatient nonadherence to cardiac medications following acute coronary syndrome (ACS) is associated with increased risk of recurrent events. However, the prevalence of cognitive dysfunction and poor health literacy among ACS patients and their association with medication nonadherence are poorly understood.MethodsWe assessed rates of cognitive dysfunction and poor health literacy among participants of a clinical trial that tested the effectiveness of an intervention to improve medication adherence in patients hospitalized with ACS. Of 254 patients, 249 completed the Rapid Estimate of Adult Literacy in Medicine, Revised (REALM-R) survey, an assessment of risk for poor literacy, and the St Louis University Mental Status (SLUMS) exam, a tool assessing for neurocognitive deficits, during ACS hospitalization. We assessed if SLUMS or REALM-R scores were associated with medication adherence.ResultsBased on SLUMS score, 14% of patients were categorized as having dementia, and 52% with mild neurocognitive disorder (MNCD). Based on REALM-R score of ≤6, 34% of patients were categorized as at risk for poor health literacy. There was no association between poor health literacy and medication nonadherence. Of those with MNCD, 35.5% were nonadherent, compared to 17.5% with normal cognitive function and 6.7% with dementia. In multivariable analysis, cognitive dysfunction was associated with medication nonadherence (P=0.007), mainly due to an association between MNCD and nonadherence (odds ratio =12.2, 95% confidence interval =1.9 to 243; P=0.007). Cognitive status was not associated with adherence in patients randomized to the intervention.ConclusionCognitive dysfunction and risk for poor health literacy are common in patients hospitalized with ACS. We found an association between MNCD and medication nonadherence in the usual care group but not in the intervention group. These findings suggest efforts to screen for MNCD are needed during ACS hospitalization to identify patients at risk for nonadherence and who may benefit from an adherence intervention.

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Section: Methodsmentioning

confidence: 99%

Cognitive dysfunction and poor health literacy are common in veterans presenting with acute coronary syndrome: insights from the MEDICATION study

Marzec¹,

Carey²,

Lambert-Kerzner³

et al. 2015

PPA

View full text Add to dashboard Cite

show abstract

“…From an international perspective, the SLUMS is available in 24 languages (http://aging.slu.edu/index.php?page=saint-louis-university-mental-status-slums-exam). 47–49 “The 5-word test” has been validated in AD (specificity 87%). It has a positive predictive value of 83% and a negative predictive value of 93%.…”

Section: Screening Instrumentsmentioning

confidence: 99%

Brain Health: The Importance of Recognizing Cognitive Impairment: An IAGG Consensus Conference

Morley

Morris²,

Berg‐Weger

et al. 2015

Journal of the American Medical Directors Association

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247

163

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Cognitive impairment creates significant challenges for patients, their families and friends, and clinicians who provide their health care. Early recognition allows for diagnosis and appropriate treatment, education, psychosocial support, and engagement in shared decision-making regarding life planning, health care, involvement in research, and financial matters. An IAGG-GARN consensus panel examined the importance of early recognition of impaired cognitive health. Their major conclusion was that case-finding by physicians and health professionals is an important step toward enhancing brain health for aging populations throughout the world. This conclusion is in keeping with the position of the United States’ Centers for Medicare and Medicaid Services that reimburses for detection of cognitive impairment as part the of Medicare Annual Wellness Visit and with the international call for early detection of cognitive impairment as a patient’s right. The panel agreed on the following specific findings: (1) validated screening tests are available that take 3 to 7 minutes to administer; (2) a combination of patient- and informant-based screens is the most appropriate approach for identifying early cognitive impairment; (3) early cognitive impairment may have treatable components; and (4) emerging data support a combination of medical and lifestyle interventions as a potential way to delay or reduce cognitive decline.

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“…Within the converter or reverser categories, the SLUMS demonstrated higher magnitude score changes and higher standard deviations than the MMSE. More individuals reversed on the SLUMS compared to the MMSE, which might be explained by the SLUMS exam’s superior detection of very mildly impaired cognition [1, 3, 4, 5, 6, 7, 8]. The higher percentage of converters, overall negative change-over-time, and more dramatic score change in converters than reversers for the MMSE could suggest that the MMSE is more sensitive than the SLUMS for detecting cognitive statuses that decline into the dementia range.…”

Section: Resultsmentioning

confidence: 99%

Detecting Change over Time: A Comparison of the SLUMS Examination and the MMSE in Older Adults at Risk for Cognitive Decline

et al. 2016

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Aims To directly compare the one-year stability of Mini-Mental State Examination (MMSE) and Saint Louis University Mental Status (SLUMS) examination scores and correlate score changes with demographic variables, clinical factors, and functional domains. Methods A sample of 304 study participants was recruited from residential and clinical settings in Ohio. Follow-up assessments were administered after one year with a retention rate of 92% (n=281). Functional domains included the Instrumental Activities of Daily Living (IADL) scale. Results MMSE and SLUMS scores correlated with each other (r=0.65, p<0.001) and with two functional measures, including the IADL (r=0.27, r=0.24, p<0.001). However, the MMSE and SLUMS frequently placed the same subject into different categories. Rates of reversion and conversion varied between the two tests. The one-year changes in MMSE raw score correlated with changes in three functional domains as well as age (p<0.05), while SLUMS raw score changes did not correlate with any functional measures. Conclusion Our large, longitudinal data set allowed us to compare the tests’ stability, which differed between the SLUMS and MMSE. The MMSE may be more sensitive than the SLUMS to one-year cognitive changes influencing functional abilities.

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Veterans Affairs Saint Louis University Mental Status Examination Compared with the Montreal Cognitive Assessment and the Short Test of Mental Status

Abstract: The SLUMS examination has validity similar to that of the MoCA and STMS for the detection of MCI, dementia, and MCI or dementia according to the CDR.

Cited by 69 publications

References 30 publications

Cognitive dysfunction and poor health literacy are common in veterans presenting with acute coronary syndrome: insights from the MEDICATION study

Cognitive dysfunction and poor health literacy are common in veterans presenting with acute coronary syndrome: insights from the MEDICATION study

Brain Health: The Importance of Recognizing Cognitive Impairment: An IAGG Consensus Conference

Detecting Change over Time: A Comparison of the SLUMS Examination and the MMSE in Older Adults at Risk for Cognitive Decline

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