St. Louis University Mental Status Exam
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- SLUMS takes about 7 minutes to administer. Scores between 0 indicate dementia. Scores between and 26 indicate mild or early dementia. Scores from 30 are considered normal. Detecting dementia earlier may lead to treatment that slows this condition or...
- Key references: Kurlowicz, L. Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12 3 Tariq, S. Comparison of the Saint Louis University mental status examination...
- The Mental Status Exam MSE In actual practice, providers with the exception of a psychiatrist or neurologist do not regularly perform an examination explicitly designed to assess a patient's mental status. During the course of the normal interview, most of the information relevant to this assessment is obtained indirectly. This review provides an opportunity to consciously think of the elements contained within the MSE. In the day to day practice of medicine and, in fact, throughout all of our interactions we continually come into contact with persons who have significantly impaired cognitive abilities, altered capacity for memory, disordered thought processes and otherwise abnormal mental status.
Saint Louis University Mental Status (SLUMS) Examination For Dementia
First and foremost, the goal is to be able to note when these abnormalities exist you'd be surprised at how frequently they can be missed and then to categorize them as specifically as possible. If a person seems "odd, confused or not quite right" what do we mean by this? What about their behavior, appearance, speech, etc. In some instances, the patient's condition e. Knowing when to "cut your losses" and abandon a more detailed examination obviously takes a bit of experience! The formulation of actual diagnoses, the final step in this process is, for the most part, beyond the scope of this discussion I've included two of the most commonly encountered ones at the end of this section as examples.- Do they know who you are? Can they tell you the day, date and year? Mood: How do they feel? You may ask this directly e. Is it appropriate for their current situation? Affect: How do they appear to you? This interpretation is based on your observation of their interactions during the interview. Do they make eye contact? Are they excitable? Does the tone of their voice change? Common assessments include: flat unchanging throughout , excitable, appropriate. Thought Process: This is a description of the way in which they think. Are their comments logical and presented in an organized fashion? If not, how off base are they? Do they tend to stray quickly to related topics? Are their thoughts appropriately linked or simply all over the map? Thought Content: A description of what the patient is thinking about. Are they paranoid?
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Delusional i. If so, about what? Hallucinating you need to ask if they see or hear things that others do not? Fixated on a single idea? If so, about what. Is the thought content consistent with their affect? If there is any concern regarding possible interest in committing suicide or homicide, the patient should be asked this directly, including a search for details e. Note: These questions have never been shown to plant the seeds for an otherwise unplanned event and may provide critical information, so they should be asked!- Memory: Short term memory is assessed by listing three objects, asking the patient to repeat them to you to insure that they were heard correctly, and then checking recall at 5 minutes. Long term memory can be evaluated by asking about the patients job history, where they were born and raised, family history, etc. Ability to perform calculations: Can they perform simple addition, multiplication?
Saint Louis University Mental Status (SLUMS) Examination - Arabic
Are the responses appropriate for their level of education? Have they noticed any problems balancing their check books or calculating correct change when making purchases? Judgment: Provide a common scenario and ask what they would do e. Higher cortical functioning and reasoning: Involves interpretation of complex ideas. For example, you may ask them the meaning of the phrase, "People in glass houses should not throw stones. Diagnoses are made on the basis of a pattern of responses to the above evaluation. This is a very common condition particularly among hospitalized patients notable for an acute, global change in mental status that can be the result of physiologic derangement anywhere within the body. Causes include: infection, hypoxia, toxic ingestion, impaired ability of the body to handle endogenously produced toxins e. There is a wide spectrum of presentations, ranging from unarousable to extremely agitated.- Patients may appear quite ill, with markedly abnormal vital signs that in themselves can suggest the cause of the delirium e. They are frequently confused, disoriented, agitated and uncooperative. Formal evaluation of mood, affect, memory, judgment or insight can be hopeless. Thought process is disordered and content notable for delusions, paranoia and hallucinations. In general, the diagnosis is suggested by the time course of the illness i. Treatment is dictated by the underlying insult, which can generally be determined after a detailed history usually with the help of others who are familiar with the patient , review of medications, thorough examination, and appropriate use of lab and radiologic testing. The elderly as well as those with multiple medical problems conditions which frequently coexist are at the highest risk for developing this condition.
- Delirium in this patient sub-set can be provoked by seemingly minor precipitants. Initial presentation of psychotic disorders as well as dementia can be mistaken for delirium and vice versa. This can only be sorted out with time and appropriate testing, though these distinctions are extremely important. For Additional Information See: Digital DDx: Delirium Dementia: A final common pathway for multiple disorders characterized by its slow, progressive nature, taking months to years to develop. While quite uncommon under 50, the incidence increases markedly with age. Patient's appearance and behavior vary with the extent of involvement. This ranges from well groomed, alert and cooperative to agitated, unable to care for themselves and incapable of answering even simple questions. Mood and affect can range widely, and may or may not be appropriate for the given situation. Thought process and content have similar variability. Memory, judgment and higher cortical function deteriorate with time.
Psychometric Properties Of The Saint Louis University Mental Status Examination
As this is a progressive disease, presentation will depend on the level of advancement. Contributions from other acute, reversible medical problems must be ruled out on the basis of history, examination and laboratory testing. Many aspects of the MSE are extremely subjective. There is tremendous potential for our own cultural exposure and background to color these assessments.- Realize that there is a major distinction between "different" and "abnormal. Thus, a "failure" to provide a correct interpretation may in fact have nothing to do with an individual's intellectual function but rather may simply reflect a different upbringing or background. Similarly, tests of memory which require the subject to recite past U. Presidents may not be an appropriate measuring tool depending on a person's country of origin, language skills, educational level, etc. These situations are unavoidable in the extremely diverse community in which we live. Quantifying and defining the nature of a specific abnormality is an important part of the practice of medicine. While it is reasonable to expect that people be aware of certain basic facts e.
- Testing Test Anywhere No paper, no problem. Complete a cognitive assessment and then save your results. Review your results conveniently on either you iPhone or iPad. Trends Paperless Tracking Clinicians look not only at the latest score but find that trends in the score may be valuable in screening for dementia. Paperless and simple. A Chinese version of this video can be found here. Some things I like about it: 1 nice clean visuals, 2 the progress bar at top right is nice, and 3 I like the graph at the end which shows the continuous data. Just use this! I wish all SLP material, including testing and treatment, can be digital, interactive and approachable like this! I am glad to see that this is a reality now. It will save on paper, unless we have to print it out. Brianna R. Full Test History [PRO] From the very first baseline tests and clock drawings to the most recent one, all this is available with just one click.
- SLUMS is an item questionnaire exam given to people for diagnosis of mild cognitive impairment and dementia with scores ranging from 0 to It is built to identify people with early or mild dementia scores through measuring orientation, attention, memory, and executive functions. SLUMS is free for anyone to use; it is not proprietary. However, the test was not effective in identifying people who have mild dementia. A group of aged people mean age, SLUMS takes about 7 minutes to administer.
- Scores between 0 indicate dementia. Scores between and 26 indicate mild or early dementia. Scores from 30 are considered normal. Detecting dementia earlier may lead to treatment that slows this condition or identifies the possible reversible causes of memory loss.
- Website: MemoryHealthCheck is a free resource to learn about human memory, the causes of memory loss, online memory loss tests, and steps you can take to improve your memory. What day of the week is it? What is the year? What state are we in? Please remember these five objects. I will ask you what they are later. Apple Pen Tie House Car5. How much do you have left? Please name as many animals as you can in one minute. What were the five objects I asked you to remember?
- For example, if I say 42, you would say This is a clock face. Please put in the hour markers and the time at ten minutes to eleven o clock. Hour markers okay Time correct Please place an X in the triangle. Which of the above figures is largest? I am going to tell you a story. Please listen carefully because afterwards, I m going to ask you some questions about was a very successful stockbroker. She then met Jack, a devastatingly handsome man. She married him and had three children. They lived in Chicago. She then stopped work and stayed at home to bring up her children. When they were teenagers, she went back to work.
Saint Louis University Mental Status (SLUMS) - Allie: Abbreviation / Long Form Info.
She and Jack lived happily ever after. What was the female s name? What work did she do? When did she go back to work? What state did she live in? Instructions for Use: 1. Complete resident demographics at the top of the page. We recommend that you put the date and the name of the evaluator on the bottom of the page as well see Administration should be conducted privately and in the examinee s primary language. Be prepared with the items you need to complete the exam. You will need a watch with a second hand on it.- Record the number of years the patient attended school. If the patient obtained an Associates, Bachelor s, Master s or Doctorate degree, note the degree achieved instead of actual years of school attended. Determine if the patient is alert. Do not answer yes or no , but indicate level of alertness. Other descriptors include: drowsy, confused, distractible, inattentive, preoccupied. Begin by asking the patient the following: Do you have any trouble with your memory? May I ask you some questions about your memory? Then proceed with the exam questions. Read the questions aloud clearly and slowly to the examinee. It is not usually necessary to speak loudly but it is necessary to speak slowly. Begin by asking the patient something similar to the following: Do you have any trouble with your memory? I d like to see how good your memory is by asking you some questions.
- You may need to reassure patients by telling them that this is not a test that they can fail but merely a tool much like a thermometer that takes temperature is a tool. What this does is checks for the amount of memory they have. Then begin to administer the exam questions. Score the questions as indicated on the examination. On question 4, read the statement as listed on the exam. Repeat them as many times as it takes for the patient to repeat them back to you correctly. On question 5, make sure the patient is focused on you prior to reciting the information. Obtain an answer for the first part of the question How much did you spend before moving on to part two How much do you have left?
- Our highly skilled examiners receive extensive training in psychometric testing and diagnostic interviewing, which enables us to provide some of the most thorough empirically based psychological assessments available. Our examiners generate objective and comprehensive reports which include empirically validated testing instruments, in-depth diagnostic interviews, behavioral observations, record reviews, and relevant collateral interviews. Some of the more common types of evaluations we provide and typical referral questions include: Cognitive Assessments gifted, intellectual disability assessments What is the nature of the client's current intellectual and adaptive functioning? A typical assessment takes three to four hours with the client and includes clinical and collateral interviews, completion of self-report and collateral behavior rating scales, cognitive testing, measures of adaptive behavior if indicated , and review of records.
Download The SLUMS Test -A Dementia / Alzheimer's Exam - Elder Guru
Collaborative Assessment Professional referral required Diagnostic Clarification Evaluations What is the client's diagnosis and what are the most appropriate treatment interventions? A typical assessment takes six to eight hours with the client and includes clinical and collateral interviews, mental status examination, completion of self-report and collateral symptom and behavior rating scales, trauma screening and assessment, personality testing, cognitive testing, ADHD testing when indicated , and review of records. Learning Disability Assessments Does the client have a learning disability or other condition that affects school performance?- Risk Assessments Is the client at risk for self-harm or under what circumstances is the client at risk of behaving violently towards others, and how can that risk be mitigated? Learn more about scheduling an appointment University of Missouri—St. Louis 1 University Blvd. Stadler Hall, , St. Louis, MO
- Saint Louis University Summary: A screening tool developed by Saint Louis University geriatricians is more sensitive at detecting mild cognitive impairment than a commonly used clinical instrument. John Morley, M. But families go through denial and sometimes miss diagnosing dementia until its symptoms are no longer mild. 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. Saint Louis University researchers used both screening tools to test men who were at least 60 and treated at the Geriatric Research Education Clinical Center, Veterans Administration Hospitals in St. Louis in They found that while both tools detected dementia, only the SLUMS recognized a group of patients as having mild cognitive problems.
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