SLUMS Exam Scoring · Saint Louis University Mental Status Exam (0-30)
The SLUMS (Saint Louis University Mental Status) exam is a clinician-administered, 11-item cognitive screen scored out of 30 that helps detect mild neurocognitive disorder and dementia in older adults. Cut-offs depend on education: with a high school education, 27 to 30 is normal, 21 to 26 mild neurocognitive disorder and 1 to 20 dementia.
For professional reference, research, and education only. Not for diagnosis or medical advice.
SLUMS Score Interpreter
Enter a total score to see its range.
11 items worth 30 points in total; higher scores indicate better cognition. The published cut-offs differ by education, so each band below says how it reads for a person with a high school education and for a person with less.
Total score Interpretation 27+ Normal27 to 30 is in the normal range at either education level. 25–26 Normal or mild neurocognitive disorder, by education25 or 26 is normal for a person with less than a high school education, and in the mild neurocognitive disorder range for a person with a high school education. 21–24 Mild neurocognitive disorder range21 to 24 is in the mild neurocognitive disorder range at either education level. Follow with a full clinical evaluation. 20 Mild neurocognitive disorder or dementia, by education20 is in the mild neurocognitive disorder range for a person with less than a high school education, and in the dementia range for a person with a high school education. 0–19 Dementia range19 or below is in the dementia range at either education level. A full clinical evaluation is needed; the SLUMS does not diagnose dementia. Saint Louis University SLUMS scoring form (high school education: 27-30 normal, 21-26 mild neurocognitive disorder, 1-20 dementia; less than high school: 25-30 normal, 20-24 mild neurocognitive disorder, 1-19 dementia), from Tariq et al. (2006). The bands here combine the two education groups so no score is misread.
The SLUMS (Saint Louis University Mental Status) exam is an 11-item, 30-point cognitive screen for older adults. Its scoring form sets separate cut-offs for people with and without a high school education [1] [2].
What does the SLUMS measure?
The SLUMS tests orientation, memory, attention and executive function [1]. It was developed at the Saint Louis University School of Medicine with the Geriatric Research, Education and Clinical Center at the St. Louis Veterans Affairs Medical Center [3], to detect mild neurocognitive disorder as well as dementia. The MMSE performs poorly at the milder end [1].
Saint Louis University describes it as a screen for mild cognitive impairment and dementia in adults aged 60 and older [3].
Terms of use
Saint Louis University calls the SLUMS a free exam and publishes the form and its translations on its website. Health care and social service professionals are asked to watch SLU's training video before administering it [3]. SLU's page carries no further licence statement, so the questions are not reproduced here; use the form from SLU.
How do you give the SLUMS?
- Who gives it. A health care or social service professional who has watched SLU's training video [3].
- Format. Face to face, with the person answering aloud and completing a drawing task. SLU notes it was not designed for telephone or virtual administration [3].
- Before you start. Record the person's level of education and whether they are alert; both are on the form [2].
- Who it is not for. SLU notes it is not suitable for people with conditions such as traumatic brain injury, developmental disabilities or schizophrenia [3].
- Accommodations. SLU gives guidance for people with vision or hearing impairment and publishes translated forms [3].
How do you score and interpret the SLUMS?
- Score each of the 11 items as the form directs; the items carry different numbers of points.
- Add the points for a total out of 30. Higher scores mean better cognitive performance.
- Read the total against the cut-offs for the person's education [2]:
| Range | High school education | Less than high school education |
|---|---|---|
| Normal | 27-30 | 25-30 |
| Mild neurocognitive disorder | 21-26 | 20-24 |
| Dementia | 1-20 | 1-19 |
The interpreter at the top of this page combines the two columns: 25 or 26 and a score of 20 read differently by education, and the band says how.
Psychometric properties
- Original study. At the St. Louis VA Geriatric Research, Education and Clinical Center, 702 patients (mean age 75.3) were classified as having normal cognition, mild neurocognitive disorder or dementia by DSM-IV criteria and given the SLUMS and the MMSE. The two had comparable sensitivity, specificity and area under the curve for dementia, but the SLUMS gave better ROC curves for mild neurocognitive disorder in both education groups [1].
- Against the MoCA. In 136 veterans aged 60 and older with at least a high school education, the area under the curve for the SLUMS was 0.74 for mild cognitive impairment, 0.98 for dementia and 0.82 for either, equivalent to the MoCA and the Short Test of Mental Status [4].
- Systematic review. A 2022 review of 20 studies found adequate validity, sensitivity and specificity, but limited normative data, little information on reliability and an unexplored factor structure [5].
Limitations
- Screening, not diagnosis. A score in the mild neurocognitive disorder or dementia range calls for a full clinical evaluation; it does not diagnose either.
- Preliminary evidence. The 2022 systematic review advised using it cautiously until its psychometric properties are better established [5].
- Education matters. The cut-offs differ by education; reading a score against the wrong column misclassifies it.
- Veteran samples. The original study and the MoCA comparison were both carried out in VA settings [1] [4], and normative data for other groups are limited [5].
- Not for every client. It is not suitable for people with traumatic brain injury, developmental disabilities or schizophrenia, or for remote administration [3].
For individuals: This page is a clinical reference, not a diagnostic tool. If you have concerns about your own symptoms, bring this information to a qualified mental health professional.
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Billing
In the US, the SLUMS Exam Scoring · Saint Louis University Mental Status Exam (0-30) is usually billed under these CPT codes. Payer rules vary.
Assessments
FAQ
What is a normal SLUMS score?
For a person with a high school education, 27 to 30 out of 30 is normal. For a person with less than a high school education, 25 to 30 is normal. These ranges are printed on the scoring form published by Saint Louis University.
What SLUMS score indicates dementia?
On the published scoring form, 1 to 20 falls in the dementia range for a person with a high school education, and 1 to 19 for a person with less than a high school education. A score in that range calls for a full clinical evaluation; the SLUMS screens, it does not diagnose.
How is the SLUMS different from the MMSE?
Both are 30-point cognitive screens. In the original study of 702 veterans, the two performed comparably for dementia, but the SLUMS was better than the MMSE at identifying mild neurocognitive disorder in both education groups. The SLUMS includes executive function tasks the MMSE lacks.
Is the SLUMS free to use?
Saint Louis University describes it as a free exam and publishes the form and translations on its website. Health care and social service professionals are asked to watch SLU's training video before administering it. This page does not reproduce the questions.
References
- 1.Tariq SH, Tumosa N, Chibnall JT, Perry MH 3rd, Morley JE. Comparison of the Saint Louis University mental status examination and the mini-mental state examination for detecting dementia and mild neurocognitive disorder--a pilot study. Am J Geriatr Psychiatry. 2006;14(11):900-10.
- 2.Saint Louis University School of Medicine, Division of Geriatric Medicine. VAMC SLUMS Examination: form and scoring.
- 3.Saint Louis University School of Medicine, Division of Geriatric Medicine. SLU Mental Status Exam: assessment tools.
- 4.Cummings-Vaughn LA, Chavakula NN, Malmstrom TK, Tumosa N, Morley JE, Cruz-Oliver DM. Veterans Affairs Saint Louis University Mental Status examination compared with the Montreal Cognitive Assessment and the Short Test of Mental Status. J Am Geriatr Soc. 2014;62(7):1341-6.
- 5.Spencer RJ, Noyes ET, Bair JL, Ransom MT. Systematic Review of the Psychometric Properties of the Saint Louis University Mental Status (SLUMS) Examination. Clin Gerontol. 2022;45(3):454-466.
Saint Louis University School of Medicine, Division of Geriatric Medicine, developed with the St. Louis VA Geriatric Research, Education and Clinical Center. SLU describes it as a free exam that professionals administer after watching its training video.
HiBoop does not offer this scale. This page is reference material.