SLUMS Test

## **What are cognitive decline and dementia?** Cognitive decline is something that happens to most, if not all, people as they get older. It slowly, gradually progresses. A person dealing with cognitive decline will start to have difficulties paying attention to things, which can impact their capacity and capability for learning. They might also develop problems with reasoning, and lapses in memory will start to become apparent. The more severe their cognitive decline is, the less they remember (Joy, 2022). Besides aging, it's possible for cognitive decline to happen because of sleep deprivation, diabetes, hypertension, vascular diseases, depression, and neurological disorders such as Alzheimer's disease and dementia. Genes can also affect one's susceptibility to it. Dementia affects at least 10 million people worldwide every year (World Health Organization, 2025), mostly older adults. It's caused by damage from certain diseases that affect the brain, specifically nerve cell damage that severs their connection to the brain (Mayo Clinic, 2025). Cognitive decline is a notable symptom of dementia, so it would be best to conduct comprehensive cognitive assessments on patients suspected of having cognitive decline and/or dementia to narrow down the potential problem causing cognitive decline. One such assessment used by qualified health care professionals is the SLUMS Test. The SLUMS Test evaluates patients' cognitive functions and cognitive domains.

## **What is the SLUMS Test?** The Saint Louis University Mental Status Test (sometimes called the Saint Louis University Mental Status Examination), or the SLUMS Test, SLUMS Exam, or VAMC SLUMS Examination for short, is one of the many cognitive screening tests (like the Mini-Mental State Examination) used by healthcare professionals to examine people suspected of having/experiencing symptoms of cognitive impairment, dementia, or the early stages of Alzheimer's Disease. This test is an 11-item questionnaire that covers different facets of a person's cognitive function, such as memory, attention, orientation, language, spatial recognition, and more! This test is quite popular, given that it is easy to administer. It only takes 10 to 15 minutes to complete (depending on the person) and can be conducted beyond a clinical setting. Do note that the SLUMS Test is a screening tool. It is not meant to be used as a standalone test for dementia diagnosis or cognitive decline. It's meant to evaluate a patient using a series of questions to see if they are exhibiting signs of experiencing cognitive decline or mild dementia. Depending on the results, the next step will always be to refer them to specialists (unless you're already a specialist) who can take your results as a reference, conduct further evaluations of their risk factors, causes of cognitive decline/dementia, check if they have regular cognitive function or not, check their executive functions, condcut brain imaging tests, and officially diagnose dementia if all the information adds up. ### **Why should you use the SLUMS Test?** The SLUMS examination works for detecting mild cognitive impairment and traumatic brain injury. So the most appropriate time to conduct it is during the initial stages of a particular person's treatment for cognitive decline or dementia. This is especially the case during screening stages when the person or their loved ones suspect they are exhibiting signs of developing either one or both. Remember that this is specifically for screening, not diagnosing. But when you are at the point where you can determine that they are possibly at risk of developing MNCD or dementia, conduct the test, then refer the examinee to another person for a more comprehensive examination of the patient. This can also be reused to monitor the examinee. Let's say they answered the test and scored high, but when you interact with them, they exhibit cognitive deficits and signs of dementia. You can reissue this test at a later time to get another look at them because they might have been in a state where they were attentive during the first time. If the examinee or their loved ones are still not convinced by their scores, even if they passed, you can still use this to track changes in their cognitive condition over time. The same goes for tracking improvements after implementing a treatment plan. ### **Is it even reliable?** As mentioned earlier, this is not meant to be used as a standalone test. This was reviewed against other cognitive screening measures/mental status exams, such as the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). The SLUMS Test is free and is often used by professionals. It has been deemed to have adequate validity, specificity, and sensitivity when it comes to assessing cognitive impairment/decline. Despite this, it doesn't have enough information concerning its test-retest reliability, explored factor structure, and normative data. It also has limited application of criterion measures, such as biomarkers and imaging studies. Given all of this, it's recommended that more research concerning this test should be conducted to establish norms. Until then, it should be used "cautiously," hence why it shouldn't be used as a standalone test (Spencer et al., 2022). Now that you know what the SLUMS Test is about, it's time to learn how it's conducted and what it asks the examinee.

## **How to use the SLUMS Test** The SLUMS Test is easy to use. It consists of 11 items, all of which are meant to be filled out by you, the examiner. What you will do is conduct the SLUMS Test like an interview. We created a template that allows you to record the specific scores of your patient, per item. It also has a second page featuring a circle and shapes because there are two items that require your patient to draw certain things. Normally, this test only has one page, but we decided to add a second page for these two items so there's room for your patient to actually draw. ### **Step 1: Download our template** If you need a copy of the SLUMS Test, you can simply click or tap on "Use template" or "Download" to obtain a PDF file of our template. You can choose to use it digitally, or you can print copies! ### **Step 2: Fill out patient details** The SLUMS Test consists of 11 items, all of which are meant to be filled out by you, the examiner. Begin by accomplishing the clerical parts of the test sheet, indicating your name, the examinee's name, the exam date, the level of education the examinee has attained, and whether they are alert. If you are wondering if it's important to note if they are alert, the answer is yes. If they are not alert, that might indicate cognitive decline. If they suddenly lose focus while you are asking them questions, that might also be a sign of cognitive decline and perhaps early signs of dementia or Alzheimer's Disease. ### **Step 3: Conduct the SLUMS Test** What you will do is conduct the SLUMS Test like an interview. Ask questions based on the items, such as the following: - What day of the week is it? - What is the year? - What state are we in? Other items require more thinking and memorizing, such as remembering five objects, naming a certain number of animals in one minute, and reciting number sequences backwards. Two items, specifically items 9 and 10, require the patient to draw. Item 9 will require them to draw the hands of a clock based on instructions, and item 10 will require them to draw an X in a triangle. That's pretty much the whole test! ### **Step 4: Calculate and interpret the scores** After the patient completes the test, calculate all the scores by adding up the scores for each item. The next steps will be based on the score range they fall under.

## **SLUMS Test scoring** For each correct answer, the patient will get a certain number of points. Here are the points associated with each question in our SLUMS Test template: #### What day of the week is it? (1 point) #### What year is it? (1 point) #### What state/city are we in? (1 point) #### Please remember these five objects: apple, pen, tie, house, and car. I will ask you about these later. (This is not scored.) #### You have USD100. You're in a store and you decide to buy a dozen apples for USD3 and a tricycle for USD20. - How much did you spend? (1 point) - How much do you have left? (2 points) #### Please name as many animals as you can in 1 minute. The score will depend on how many they are able to name: - 0 to 4 animals (0 points) - 5-9 animals (1 point) - 10-14 animals (2 points) - 15+ animals (3 points) #### What are the five objects I asked you to remember? (1 point for each one named, so they can score a total of 5 points.) #### I am going to give you a series of numbers and I would like you to give them to me backward. For example, if I say 42, you would say 24. - 87 (0 points) - 649 (1 point) - 8537 (2 points) - NOTE: They can only score up to 2 points for this number, so they have two opportunities to score. #### This is a clock face. Please put in the hour markers and the time at ten minutes to eleven o'clock. - See attached for a larger clock. - Hand them the second sheet, which has the clock circle. - If the sequence of the hour markers is legible and correct, they get 2 points. - If they draw the clock hands to point at eleven o'clock, they get 2 points. - NOTE: They can score up to 4 points for this number. #### Two-part number: - Please place an X in the triangle. (1 point) - Which of the above figures is the largest? (1 point) - This is also part of the second sheet. - NOTE: They can score up to 2 points for this number. #### I am going to tell you a story. Please listen carefully because afterward, I'm going to ask you some questions about it. Jill was a very successful stockbroker. She made a lot of money on the stock market. She then met Jack, a devastatingly handsome man. She married him and had three children. They lived in Chicago. She then stopped work and stayed home to bring up her children. When they were teenagers, she went back to work. She and Jack lived happily ever after. - What was the female's name? (2 points) - When did she go back to work? (2 points) - What work did she do? (2 points) - What state did she live in? (2 points) - NOTE: They can score up to 8 points for this number. Tally up the scores, then prepare for the SLUMS scoring interpretation.

## **How to score the SLUMS Test:** Now that you know the questions, it's time to know more about the SLUMS score interpretation. For your benefit, in the previous section, we indicated the allocated points per question and how many points they can get per item. All you need to do is tally the scores based on their answers. Once you have tallied the scores, refer to this SLUMS test scoring table. First, consider if the patient you're evaluating for cognitive impairment and potential dementia has had a high school education or higher, or if they have less than that. If they are a high school graduate, refer to the range on the first column. Otherwise, refer to the third. Then, compare their score to the ranges indicated. #### **If the patient has high school education and above** - Normal = 27 to 30 points - MNCD (Mild neurocognitive disorder) = 21 to 26 points - Dementia = 1 to 20 points ### **If the patient has less than a high school education** - Normal = 25 to 30 points - MNCD = 20 to 24 points - Dementia = 1 to 19 points The patient's score determines what category they are in. Please note that, despite the SLUMS scoring designations, this doesn't mean you can diagnose a test taker with MNCD or dementia using this assessment tool. It can only help with detecting dementia signs. What you should do based on a low SLUMS score is endorse an examinee for further testing to check if they do have MNCD or dementia, so that they can get officially diagnosed and treated.

## **Similar tools you can use** Another assessment worth conducting is the [Mini-Mental State Examination](https://www.carepatron.com/templates/mini-mental-state-examinations), which can help detect mild cognitive impairment and more severe levels of cognitive function decline. This is similar to the SLUMS Test and is often used to assess older adults. For this test, patients have to do the following: - Memorize and recall a list of items - Compose short sentences with proper grammar - Replicate a specific drawing from the examination - Recognize the current day, date, month, year, and season accurately - Identify their current location Another tool we have is the [Neurocognitive Test](https://www.carepatron.com/templates/neurocognitive-test), which is a self-report assessment that allows your patient to reflect on their cognition, specifically the strength of their memory, attention, concentration, executive function, processing speed, language skills, neurological and motor skills, their mood, and if they feel anxious. Self-reports are good because you can at least gauge what the patient thinks about themself in terms of their cognition. We also have an [Early Signs of Dementia Checklist ](https://www.carepatron.com/templates/early-signs-of-dementia-checklist)that you can hand to your patient's loved ones, friends, and other people who are constants in their lives. This allows them to tick off any observations that may be signs of dementia/cognitive decline. This is a great tool to have when gathering information about a patient. You can detect consistencies in observations from the people closest to the patient.

## **References** Joy, R. (2022, October 5). Understanding Cognitive Decline: How Your Brain Changes as You Age. Healthline; Healthline Media. https://www.healthline.com/health/cognitive-decline#definition Mayo Clinic. (2025, June 7). Dementia - symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc-20352013 Spencer, R. J., Noyes, E. T., Bair, J. L., & Ransom, M. T. (2022). Systematic Review of the Psychometric Properties of the Saint Louis University Mental Status (SLUMS) Examination. Clinical Gerontologist, 45(3), 1–13. https://doi.org/10.1080/07317115.2022.2032523 World Health Organization. (2025, March 31). Dementia. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/dementia