Sensitivity and Specificity of the Saint Louis University Mental Status Examination to Detect Mild Cognitive Impairment and Dementia in Chinese Population

Ya-Ping Yang; Ying-Che Huang; Cheng-Sheng Chen; Yi-Ching Yang; Jing-Jy Wang

doi:10.1159/000511904

Sensitivity and Specificity of the Saint Louis University Mental Status Examination to Detect Mild Cognitive Impairment and Dementia in Chinese Population

Gerontology. 2021;67(2):152-159. doi: 10.1159/000511904. Epub 2021 Jan 21.

Authors

Ya-Ping Yang¹, Ying-Che Huang², Cheng-Sheng Chen³, Yi-Ching Yang⁴, Jing-Jy Wang⁵

Affiliations

¹ Department of Nursing, National Tainan Junior College of Nursing, Tainan, Taiwan, ypyang@ntin.edu.tw.
² Department of Neurology, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan.
³ Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁴ Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁵ Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

PMID: 33477133
DOI: 10.1159/000511904

Abstract

Introduction: The Saint Louis University Mental Status (SLUMS) examination is a common screening instrument to detect mild cognitive impairment (MCI) in Western countries. However, further work is needed to identify optimal SLUMS cutoff scores for screening MCI and dementia in Chinese populations.

Objective: The aim of this study was to evaluate the utility and diagnostic accuracy of the SLUMS examination in the diagnosis of dementia and MCI in Chinese population.

Methods: A cross-sectional multicenter design was conducted. Patients were recruited from the outpatient department of our neurology and psychiatric clinics. The establishment of the gold standard for the SLUMS-Chinese version (SLUMS-C) to detect MCI and dementia was based on the clinical criteria of the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) and related neuropsychological testing conducted by 3 certified dementia specialists. The consistency of the diagnosis process and administering SLUMS-C were established prior to the beginning of the study. Data were analyzed, and sensitivity, specificity, and areas under the curve (AUCs) were calculated.

Results: A total of 367 subjects were recruited. The SLUMS-C did not show satisfactory AUCs for the preliminary detection of normal cognitive status and MCI by different educational levels (all AUC 0.32-0.54). However, the SLUMS-C showed acceptable AUCs for the preliminary detection of dementia by different educational levels (all AUC 0.78-0.81). An educational level of senior high school showed the best cutoff, sensitivity, and specificity. The SLUMS-C scores to detect dementia for individuals with at least high school education and less than high school education were <24 and 22, respectively.

Conclusions: Our results indicate that the SLUMS-C could be a beneficial and convenient screening instrument to detect dementia in Chinese population. After community screening, a comprehensive clinical evaluation including cognitive assessment, functional status, corroborative history, and imaging confirmation is needed.

Keywords: Areas under the curve; Chinese population; Dementia; Mild cognitive impairment; The Saint Louis University Mental Status examination.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
China / epidemiology
Cognitive Dysfunction* / diagnosis
Cross-Sectional Studies
Dementia* / diagnosis
Geriatric Assessment
Humans
Mental Status Schedule
Neuropsychological Tests
Sensitivity and Specificity
Universities