TY - JOUR
T1 - Cognitive deficit reversal as shown by changes in the veterans affairs Saint Louis University Mental Status (SLUMS) examination scores 7.5 years later
AU - Cruz-Oliver, Dulce M.
AU - Malmstrom, Theodore K.
AU - Roegner, Michael
AU - Tumosa, Nina
AU - Grossberg, George T.
N1 - Funding Information:
The authors thank study participants and acknowledge support from the Department of Internal Medicine, Division of Geriatric Medicine, Saint Louis University School of Medicine , and the Geriatric Research, Education, and Clinical Center (GRECC) at the Department of Veterans Affairs in St Louis, MO . They also thank Virginia Owens and Chris Allen, MS, BS, for assistance with data collection.
PY - 2014/9
Y1 - 2014/9
N2 - Objective: The Veterans Affairs Saint Louis University Mental Status (SLUMS) examination is a screening tool that has the sensitivity to detect mild neurocognitive impairment and dementia. This study explores patients' cognitive impairment trajectories based on the SLUMS examination score changes after 7.5 years. Design: Retrospective chart review. Setting: The Geriatric Research, Education, and Clinical Center at the Department of Veterans Affairs Medical Center (VAMC), St Louis, MO. Participants: A review of 533 charts indicated that 357 patients who had participated in the SLUMS examination validation study in 2003 were still alive. Measurement: Charts were screened for indicators of cognitive status in both 2003 and 2010 and interventions after baseline evaluation. Results: The mean age of the 357 individuals in 2003 was 74, all were men, and 73% had a high school education or more. A total of 223 (62%) of the 357 completed the SLUMS examination at baseline and at the 7.5-year follow-up visit; of those, 33 (15%) progressed to mild cognitive deficit, 20 (9%) progressed to severe cognitive deficit, and 53 (24%) improved or reverted back to normal. Further exploration revealed that at least one reversible cause was identified for most (n= 36/53, 68%) of the reversions. The primary interventions that differentiated reversers from nonreversers were correction of visual loss (P= .005) and discontinuation of anticholinergic medications (P= .002). Conclusion: Cognitive improvement (reversion) as indicated by the SLUMS examination after 7.5 years was associated with the correction of some reversible causes. This stresses the importance of early detection and exclusion of reversible causes for persons screened for cognitive dysfunction using the SLUMS examination.
AB - Objective: The Veterans Affairs Saint Louis University Mental Status (SLUMS) examination is a screening tool that has the sensitivity to detect mild neurocognitive impairment and dementia. This study explores patients' cognitive impairment trajectories based on the SLUMS examination score changes after 7.5 years. Design: Retrospective chart review. Setting: The Geriatric Research, Education, and Clinical Center at the Department of Veterans Affairs Medical Center (VAMC), St Louis, MO. Participants: A review of 533 charts indicated that 357 patients who had participated in the SLUMS examination validation study in 2003 were still alive. Measurement: Charts were screened for indicators of cognitive status in both 2003 and 2010 and interventions after baseline evaluation. Results: The mean age of the 357 individuals in 2003 was 74, all were men, and 73% had a high school education or more. A total of 223 (62%) of the 357 completed the SLUMS examination at baseline and at the 7.5-year follow-up visit; of those, 33 (15%) progressed to mild cognitive deficit, 20 (9%) progressed to severe cognitive deficit, and 53 (24%) improved or reverted back to normal. Further exploration revealed that at least one reversible cause was identified for most (n= 36/53, 68%) of the reversions. The primary interventions that differentiated reversers from nonreversers were correction of visual loss (P= .005) and discontinuation of anticholinergic medications (P= .002). Conclusion: Cognitive improvement (reversion) as indicated by the SLUMS examination after 7.5 years was associated with the correction of some reversible causes. This stresses the importance of early detection and exclusion of reversible causes for persons screened for cognitive dysfunction using the SLUMS examination.
KW - Dementia
KW - Mild cognitive impairment
KW - SLUMS examination
KW - Screening
UR - http://www.scopus.com/inward/record.url?scp=84906935241&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84906935241&partnerID=8YFLogxK
U2 - 10.1016/j.jamda.2014.05.004
DO - 10.1016/j.jamda.2014.05.004
M3 - Article
C2 - 24953686
AN - SCOPUS:84906935241
SN - 1525-8610
VL - 15
SP - 687.e5-687.e10
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 9
ER -