title: 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.
  
  
  METHODS
  Longitudinal study.
  
  
  METHODS
  Geriatric Research, Education and Clinical Center Veterans Affairs Hospital St. Louis, MO.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  The SLUMS exam and MMSE both predict mortality and institutionalization for male patients screened as positive for dementia.
authors: Division of Geriatrics, Department of Internal Medicine, Saint Louis University,1402 South Grand Blvd M238 St Louis, MO 63104, USA. dcruzoli@slu.edu
authors: D M
authors: DM
authors: Cruz-Oliver
authors: T K
authors: TK
authors: Malmstrom
authors: C M
authors: CM
authors: Allen
authors: N
authors: N
authors: Tumosa
authors: J E
authors: JE
authors: Morley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000401:mortality* / Q000523:psychology; D003704:Dementia / Q000401:mortality* / Q000523:psychology; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule; D009026:Mortality / Q000639:trends*; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D014728:Veterans / Q000706:statistics & numerical data*