St. Louis University Mental Status

Overview

Author(s): Tumosa, N., Chibnall, J., Perry, III, M., & Morley, J.

Year of Publication: 2006

Publisher: Saint Louis University, School of Medicine & the Geriatrics Research, Education & Clinical Center at St. Louis Veterans Administration Medical Center

Type of Assessment: 

• Standardized

• Performance-based

• Criterion-referenced

Cost: Free

How to Access: https://www.slu.edu/medicine/internal-medicine/geriatric-medicine/aging-successfully/assessment-tools/mental-status-exam.php 

Age: Older Adults (60+)

Diagnoses: Age-related changes, MCI, & dementia

Setting: inpatient rehab, outpatient rehab, skilled nursing facilities, assisted living, acute care, 

Areas Assessed:

• Attention & orientation

• Short-term & working memory 

• Delayed & immediate recall

• Calculation

• Language & verbal fluency

• Executive function

• Visuospatial ability

Administration 

Time: 15 mins

Group/Individual: Individual

Subtests: 11 questions with 8 subsections

Instructions: Begin by completing client demographics, client alertness, and assess client's overall memory to introduce the task (e.g. "Do you have any trouble with your memory?") then proceed with exam questions.

• Questions should be read aloud clearly and slowly to examinee

• *For item 6, give them one minute to complete the question and be sure to time them

• *Prompting is not permitted

• *All items must be administered and scored; any classifications will not be valid if items are excluded or modified

• *Extra aids or resources are not allowed

Materials: evaluation form, watch with a second hand & pencil

User Qualifications: Training videos should be viewed before administering then reviewed annually

Scoring Procedures

How to Score: Scoring is indicated on the examination for each question

• *Scores that are self-corrected can be accepted as correct

• *Score ranges depend on the client's education level

Score Indications:

• High School Education:

  • Normal = 27-30

  • Mild Neurocognitive Disorder = 21-26

  • Dementia = 1-20

• Less than High School Education:

  • Normal = 25-30

  • Mild Neurocognitive Disorder = 20-24

  • Dementia = 1-19

Psychometrics

Reliability: 

• Test-retest reliability: indicates that the test produces consistent results when administered multiple times to the same individual.

  • ICC = 0.86-0.90

Validity: Excellent

• Concurrent validity with MMSE

Specificity: Good

Sensitivity: Good

Pros & Cons

Strengths: 

• Quick, easy to administer and score

• Performance-based reduces risk of self-report bias

• Validated translated versions in 23 languages including German, Chinese, Arabic, etc.

• Taken without aids such as calculators/clock to assess client's raw abilities 

Weaknesses: 

• Is not admissible in audio form

• Items cannot be modified or adapted for client's needs

• Cannot be taken more than once per year due to memory recall creating testing bias

• Not a measure of global cognitive function and results do not represent a clinical diagnosis, requiring a full assessment based on DSM-V criteria

References

•  Asher, I. E. (2014). Asher’s occupational therapy assessment tools: An annotated index (4th ed.). AOTA Press.

• Saint Louis University School of Medicine. (n.d.). SLU Mental Status Exam. https://www.slu.edu/medicine/internal-medicine/geriatric-medicine/aging-successfully/assessment-tools/mental-status-exam.php 

• Tariq, S. H., Tumosa, N., Chibnall, J. T., Perry, M. H. III, & Morley, J. E. (2006). 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. American Journal of Geriatric Psychiatry, 14(11), 900–910.