New Dementia Screening Tool Detects Early Cognitive Problems Missed By Commonly Used Test

Physicians routinely administer the Mini Mental Status Examination (MMSE) to patients who they believe may have Alzheimer's disease. Both the MMSE and SLU's screening tool --- the Saint Louis University Mental Status Examination (SLUMS) --- indicate to doctors when they should pursue further testing in diagnosing dementia.

"This early detection of mild neurocognitive disorder by the SLUMS offers the opportunity for the clinicians to begin early treatment as it becomes available," says Syed Tariq, M.D., lead author and associate professor of geriatric medicine at Saint Louis University.

John Morley, M.D., director of the division of geriatric medicine at Saint Louis University, created the SLUMS to screen more educated patients and to detect early cognitive problems.

"There are potential treatments available and they slow down the progression of the disease," says Morley, who is a coinvestigator. "The earlier you treat, the better people seem to do. But families go through denial and sometimes miss diagnosing dementia until its symptoms are no longer mild."

The researchers found the new screening tool developed by SLU detects early cognitive problems missed by the MMSE.

"The Mini Mental Status Examination has limitations, especially with regard to its use in more educated patients and as a screen for mild neurocognitive disorder," Tariq says.

It takes a clinician about seven minutes to administer the SLUMS, which supplements the Mini Mental Status Examination by asking patients to perform tasks such as doing simple math computations, naming animals, recalling facts and drawing the hands on a clock.

Both screening tools work at detecting dementia, the research found.

"SLUMS has the advantage in that it can help the clinician identify patients with mild neurocognitive disorder on the initial visit compared to MMSE, which requires a follow up screening," Tariq says.

Saint Louis University researchers used both screening tools to test 705 men who were at least 60 and treated at the Geriatric Research Education Clinical Center, Veterans Administration Hospitals in St. Louis in 2003. They found that while both tools detected dementia, only the SLUMS recognized a group of patients as having mild cognitive problems.

The SLUMS, which is free and currently used at many Veterans Administration hospitals, is available at this link http://medschool.slu.edu/agingsuccessfully/pdfsurveys/slumsexam_05.pdf

The researchers cautioned that neither the SLUMS nor the MMSE screening tools substitute for clinical assessment and neuropsychological testing to diagnose cognitive problems and dementia.

The study appeared in the November issue of the American Journal of Geriatric Psychiatry.