SLUMS stands for the St. Louis University Mental Status Exam and the test examines a patient’s cognitive ability. It is an early diagnostic tool that is used to help form an early diagnosis of Alzheimer’s or other dementias. SLUMS in itself is not sufficient to provide an accurate diagnosis, but rather it is one of many tools used in the process.

Alzheimer’s and most dementias are progressive diseases, meaning there is no cure. There are pharmaceutical, therapeutic, and alternative treatments that can manage symptoms. For example, memory loss can be slowed down. The earlier the disease is identified, the more effective these treatments will be. Therefore, non-invasive tests are helpful in your loved one’s quality of life. The following is everything you need to know about the SLUMS exam, including where to get it, how it works, and how the test is administered.

 

What is the SLUMS Exam?

The SLUMS test is an early detection tool for caregivers and health care professionals to assess patients’ brain function to determine if there is a normal aging process in the brain or if there are early signs of Alzheimer’s and dementia. This cognitive ability exam is an 11-question test that takes approximately 10 minutes to complete. SLUMS tests thought processes, logical sequences, and problem-solving. It examines the strategies one’s brain uses instead of its accumulated knowledge.

Cognitive abilities and processes are used daily and range from talking on the phone to telling time and following directions. Through this 10-minute noninvasive exam, your loved one can complete an assessment. By testing cognitive abilities, specific parts of the brain are highlighted to see how well they are performing. A problem with some of the non-invasive exams for dementia is that results can be inaccurate depending on how much school has been completed by the patient. The SLUMS exam uses different scoring values for those who have graduated high school and those who have not. Patients fall into three categories based on their scores:

– Mental capabilities are functioning “normally”.
– Mental capabilities are functioning showing signs of a mild neurocognitive disorder, a pre-symptom of dementia.
– Mental capabilities are functioning showing signs of dementia.

This test is meant to be given and scored by healthcare professionals. This is a free exam developed by the University of St. Louis. Resources through the university are available here. There is an eight-and-a-half-minute training video and a downloadable pdf. With these materials, it is possible to do this test at home. Even though it is not recommended, The SLUMS exam is simple and be completed informally at home with the help of a caregiver or family member.

 

How Does It Work?

The SLUMS test examines how the brain is working through its cognitive ability. This is an easy early detection tool that asks patients 11 questions. This test centers around asking patients questions about time, place, and short-term memory. The SLUMS exam focuses on:

– The orientation to their time and place. This tests if a patient knows when and where they are or what day of the week it is.
– Ability to concentrate and follow directions during a test that lasts about 10 minutes.
– Short-term memory by seeing if they can recall something or a series of items.
– Language capabilities through verbal skills using memory and naming.
– The relationship between different objects. This is testing visuospatial skills.
– The ability to solve problems.
– Motor skills by doing a Clock Drawing Test
– Simple math problems to solve

 

Pros and Cons

All tests have their advantages and disadvantages. For the SLUMS test, they are:

Pros:
– Focuses on finding early “deficits”. This means small abnormalities in the brain are detected leading to earlier diagnosis.
– Non-invasive
– Free
– Preformed quickly, normally taking about 10 minutes

Cons:
– Not as commonly used in comparison to other early diagnostic dementia tests.
– Less research proving it is effective at diagnosing Alzheimer’s in its earliest stages.

 

Accuracy

The SLUMS test has proven to be an early diagnostic tool, but not widely used to diagnose patients. Because it is a lesser common test, there are not a lot of studies to prove its effectiveness. So far, research has shown that this is a test that can successfully diagnose differences in the earliest stages in a patient’s brain who has “cognitive impairment”.

Studies have shown that a patient’s level of education can overcompensate for early symptoms leading to scoring better on the exam. SLUMS adjusts the scoring guide on the 30-point exam. This makes it so that the results are more “sensitive” and able to see the first signs of MCI which research shows is a pre-symptom of dementia. There is an advantage of taking into account a patient’s education, having different scoring values for those with and without a high school diploma.

In a major study, the SLUMS test proved it was able to pick up on the small differences enabling a credible way to diagnose Alzheimer’s early.

 

How to Administer

The SLUMS exam is a tool that was created to be used by medical professionals. The University of St. Louis offers free resources for examiners. There is a downloadable pdf of the exam along with an instructional video that explains how to give and score it.

According to St. Luis University, this is a diagnostic tool meant for doctors and nurses to use. That means that the SLUMS exam is supposed to be administered by a healthcare professional who watched a training video. A link to the free online materials is available here.

 

Interpreting the Results

The SLUMS exam is an early diagnostic tool that helps pinpoint if there is a breakdown of brain function. A low score does not mean that there is a diagnosis of Alzheimer’s or dementia. This is a tool that is meant to be used with other evaluations that lead doctors to a diagnosis. Scoring depends on level of education.

For people who have graduated high school:
– 27-30 means that their “cognitive function” is working properly
– 21-26 means that there is mild cognitive impairment (MCI), which can be a pre-symptom of dementia
– 0-20 means that the patient has dementia

For people who have not have a high school diploma:
– 25-30 means that their “cognitive function” is working properly
– 20-24 means that there is mild cognitive impairment (MCI), which can be a pre-symptom of dementia
– 0-19 means that the patient has dementia

 

Alternatives and Comparisons

Compared to MMSE
SLUMS is more comprehensive than the Mini-Mental State Exam. With the MMSE, the amount of education completed can give a patient a higher score. That can lead to the belief that a patient’s brain health is better than it is. The SLUMS test is more “sensitive”. It positively identifies the early stages of dementia in patients who have passed other exams. SLUMS questions and scoring system all lead to picking up on smaller changes in the brain which leads to early detection and treatment.

Compared to MoCA
Shorter than the MoCA, but has proven to be just as accurate. The benefit of the SLUMS exam is that it usually takes about half the time to take.

Compared to the Clock Drawing Test
The Clock Drawing Test is a straightforward way to determine if someone shows signs of dementia. In it, a person is asked to draw a clock showing the time as “10 past 11.” Someone with dementia will draw the clock incorrectly in several ways. This is a much easier means of seeing if someone needs to be evaluated further for dementia and can be taken at home in just a few minutes with nothing but a piece of paper and a pencil. The benefit of SLUMS is that it has the Clock Drawing Test in addition to asking questions focusing on short-term memory and location. By having the added layer of memory recall, it becomes a more “sensitive” test offering the advantage of an early diagnosis.