Clinical utility of the Saint Louis University Mental Status Examination (SLUMS) in a mixed neurological sample: Proposed revised cutoff scores for normal cognition, mild cognitive impairment, and dementia.

Abstract

Early detection of cognitive impairment is of paramount importance in clinical settings, with several brief screening tools having been developed for that purpose. The present study sought to evaluate the clinical utility of the Saint Louis University Mental Status examination (SLUMS) at identifying examinees with normal cognition, mild cognitive impairment, or dementia syndrome using the criterion of a comprehensive neuropsychological assessment. Two hundred sixty-three examinees (M age = 67.84 ± 12.72; 59.3% female; 81.4% white) were referred for comprehensive neuropsychological evaluation at a private, Mid-Atlantic medical center. Using original cutoff scores, the SLUMS correctly classified just over half (55.1%) of examinees. Classification statistics suggested modified cutoff scores for mild cognitive impairment (≤24) and dementia (≤17) with strong discriminability between cognitive status groups (AUCs ranged from .834 to .986). These proposed revised cutoff scores improved overall concordance between SLUMS and diagnostic conclusions from comprehensive clinical neuropsychological testing, correctly classifying nearly two-thirds of examinees (65.4%). The SLUMS and its revised cutoff scores appear to have clinical utility for cognitive screening in primary care and neurological settings to inform treatment plans and appropriate referrals for comprehensive neuropsychological assessment.