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圣路易斯大学精神状态检查(SLUMS)在混合神经样本中的临床实用性:正常认知、轻度认知障碍和痴呆的建议修订截断分数。

Clinical utility of the Saint Louis University Mental Status Examination (SLUMS) in a mixed neurological sample: Proposed revised cutoff scores for normal cognition, mild cognitive impairment, and dementia.

机构信息

LeBauer Department of Neurology, Moses H. Cone Memorial Hospital, Greensboro, NC, USA.

Section of Neuropsychology, Cleveland Clinic, Neurological Institute, Cleveland, OH, USA.

出版信息

Appl Neuropsychol Adult. 2024 Sep-Oct;31(5):1024-1031. doi: 10.1080/23279095.2022.2106572. Epub 2022 Aug 5.

Abstract

Early detection of cognitive impairment is of paramount importance in clinical settings, with several brief screening tools having been developed for that purpose. The present study sought to evaluate the clinical utility of the Saint Louis University Mental Status examination (SLUMS) at identifying examinees with normal cognition, mild cognitive impairment, or dementia syndrome using the criterion of a comprehensive neuropsychological assessment. Two hundred sixty-three examinees ( age = 67.84 ± 12.72; 59.3% female; 81.4% white) were referred for comprehensive neuropsychological evaluation at a private, Mid-Atlantic medical center. Using original cutoff scores, the SLUMS correctly classified just over half (55.1%) of examinees. Classification statistics suggested modified cutoff scores for mild cognitive impairment (≤24) and dementia (≤17) with strong discriminability between cognitive status groups (AUCs ranged from .834 to .986). These proposed revised cutoff scores improved overall concordance between SLUMS and diagnostic conclusions from comprehensive clinical neuropsychological testing, correctly classifying nearly two-thirds of examinees (65.4%). The SLUMS and its revised cutoff scores appear to have clinical utility for cognitive screening in primary care and neurological settings to inform treatment plans and appropriate referrals for comprehensive neuropsychological assessment.

摘要

早期发现认知障碍在临床环境中至关重要,为此已经开发了几种简短的筛查工具。本研究旨在使用综合神经心理学评估的标准,评估圣路易斯大学精神状态检查 (SLUMS) 在识别认知正常、轻度认知障碍或痴呆综合征患者方面的临床效用。263 名被试者(年龄=67.84±12.72;59.3%为女性;81.4%为白人)因在一家私人的大西洋中部医疗中心进行全面的神经心理学评估而被转诊。使用原始截断分数,SLUMS 正确分类了超过一半(55.1%)的被试者。分类统计数据表明,对于轻度认知障碍(≤24)和痴呆(≤17),修改后的截断分数具有很强的辨别力(AUC 范围从.834 到.986)。这些建议的修订后的截断分数提高了 SLUMS 与全面临床神经心理学测试的诊断结论之间的总体一致性,正确分类了近三分之二的被试者(65.4%)。SLUMS 及其修订后的截断分数似乎在初级保健和神经科环境中的认知筛查中具有临床效用,可告知治疗计划和适当转介进行全面的神经心理学评估。

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