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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

The journal of nutrition, health & aging volume 16, pages 636–641 (2012)Cite this article

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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Author information

Authors and Affiliations

  1. Division of Geriatric Medicine, Saint Louis University Medical School, St Louis, MO, 63104, USA

    Dulce M. Cruz-Oliver, C. M. Allen, N. Tumosa & J. E. Morley

  2. Department of Neurology & Psychiatry, Saint Louis University Medical School, St Louis, MO, 63104, USA

    T. K. Malmstrom

  3. Division of Geriatrics, Department of Internal Medicine, Saint Louis University, 1402 South Grand Blvd M238, St Louis, MO, 63104, USA

    Dulce M. Cruz-Oliver

Authors
  1. Dulce M. Cruz-Oliver
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  2. T. K. Malmstrom
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  3. C. M. Allen
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  4. N. Tumosa
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  5. J. E. Morley
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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