Comparison of the Saint Louis University Mental Status Examination, the Mini-Mental State Examination, and the Montreal Cognitive Assessment in Detection of Cognitive Impairment in Chinese Elderly from the Geriatric Department

Introduction: The Saint Louis University Mental Status (SLUMS) examination is a popular screening scale for cognitive impairment in North America but has not been studied in Chinese populations. The aim of this study is to compare consistency of the SLUMS with the Chinese version of Mini-Mental Status Examination (CMMSE) and the Beijing version of Montreal Cognitive Assessment (MoCA-B) in Chinese elderly.

Methods: Two hundred seventy-eight Chinese elderly with chronic diseases and geriatric syndromes from the geriatrics department were screened for cognitive impairment, including dementia and mild cognitive impairment, using SLUMS, CMMSE, and MoCA-B. The modified education level cutoff in the diagnostic criteria of SLUMS (mSLUMS) was explored. Scores of the scales and classifications for cognitive status by them were compared using Spearman and κ statistics, respectively.

Results: Spearman correlation coefficient between scores of the scales were 0.747 (SLUMS vs CMMSE, P < .001), 0.839 (SLUMS vs MoCA-B, P < .001), and 0.773 (CMMSE vs MoCA-B, P < .001). For detection of dementia, κ values were 0.462 (SLUMS vs CMMSE, P < .000) and 0.484 (mSLUMS vs CMMSE, P < .000). For mild cognitive impairment, κ values were 0.123 (SLUMS vs CMMSE plus MoCA-B in parallel, P = .089) and 0.148 (mSLUMS vs CMMSE plus MoCA-B in parallel, P = .031). For all cognitive impairment, κ values were 0.562 (SLUMS vs MoCA-B, P < .000) and 0.650 (SLUMS vs MoCA-B, P < .000).

Conclusion: Findings from our study indicate that the scores of SLUMS are fairly consistent with MoCA-B and CMMSE in Chinese elderly. Discrepancies of classifications for cognitive status by SLUMS and the other 2 scales implies that further work is needed to explore optimal cutoffs of SLUMS for screening mild cognitive impairment and dementia in elderly Chinese.