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The veterans affairs Saint Louis University mental status exam (slums exam) and the mini-mental status exam as predictors of mortality and institutionalization

Abstract

Objective

To evaluate predictive validity of cognitive dysfunction of the Saint Louis University Mental Status (SLUMS) exam or Mini-Mental State Exam (MMSE) for institutionalization and mortality after 7.5-years.

Design

Longitudinal study.

Setting

Geriatric Research, Education and Clinical Center Veterans Affairs Hospital St. Louis, MO.

Participants

Patients (N=705) were screened for cognitive dysfunction in 2003 using the SLUMS exam and MMSE, and mortality and institutionalization up to 7.5-years later were evaluated as outcome measures.

Measurement

The associations between outcome measures and MMSE and SLUMS exam total scores, and cognitive status were examined using Kaplan-Meier curves and Cox proportional-hazards regression.

Results

Five hundred thirty-three charts were reviewed, 176/533(33%) patients had died and 31/526 (6%) were institutionalized during 7.5-year follow-up period. All subjects were male with a mean age of 75 years and most had high school education or greater (71%). MMSE dementia, SLUMS dementia (ps<.001) and MCI (p<.05) groups had significantly lower survival rates than normal cognition group in the Kaplan-Meier curves. Scores classified as dementia on SLUMS (HR=2.4, 95% CI 1.6–3.7; p <.001) or MMSE (HR=2.3, 95% CI 1.5–3.6; p <.001) both predicted mortality and, also, institutionalization (SLUMS: HR=3.5, 95% CI 1.3–9.1; p <.01; MMSE: HR=3.8, 95% CI 1.6–9.0; p <.001) after adjustment for covariates. Unadjusted SLUMS exam MCI predicted morality (HR=1.5, 95% CI 1.1–2.2; p <.019) but not institutionalization.

Conclusion

The SLUMS exam and MMSE both predict mortality and institutionalization for male patients screened as positive for dementia.

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Correspondence to Dulce M. Cruz-Oliver.

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Cruz-Oliver, D.M., Malmstrom, T.K., Allen, C.M. et al. 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 16, 636–641 (2012). https://doi.org/10.1007/s12603-012-0098-9

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  • DOI: https://doi.org/10.1007/s12603-012-0098-9

Key words

  • Dementia
  • mild cognitive impairment
  • SLUMS exam
  • MMSE
  • mortality
  • institutionalization