Preliminary study of the validity and reliability of the Chinese version of the Saint Louis University Mental Status Examination (SLUMS) in detecting cognitive impairment in patients with traumatic brain injury

Abstract

The Saint Louis University Mental Status Examination (SLUMS) has been shown to be useful in the cognitive assessment in older adults and patients with dementia. The aim of this study was to preliminarily explore the effectiveness of the Chinese version of the SLUMS in the detection of cognitive impairment in patients with traumatic brain injury (TBI) and to provide an objective basis for its clinical application in China. In this cross-sectional study, 42 patients with TBI and 30 matched normal controls were administered. Participants were assessed by the Chinese version of the Mini-Mental State Assessment scale (MMSE), Montreal Cognitive Assessment scale (MoCA) and SLUMS. Results showed that the Chinese version of the SLUMS had satisfactory internal consistency (Cronbach's α coefficient: 0.723), excellent interrater reliability (ICC: 0.990–0.998) and intrarater reliability (ICC: 0.968), as well as good validity. In the TBI group, the total SLUMS score was moderately positively correlated with the MMSE score (r = 0.702, p = .000) and highly positively correlated with the MoCA score (r = 0.831, p = .000). Receiver Operating Characteristic (ROC) curve analyses showed that the area under the curve (AUC) of the SLUMS, MMSE and MoCA were 0.872, 0.756 and 0.916, respectively. The optimal cutoff score of 22.5 or fewer points are suggested for the SLUMS to discriminate cognitive impairment, with a sensitivity of 0.844 and a specificity of 0.825. The Chinese version of the SLUMS has excellent reliability and validity, and can be used as a screening tool for cognitive impairment of patients with TBI in China.