COMPARISON OF THE SLUMS WITH MMSE TO DETECT COGNITIVE IMPAIRMENT IN INDIAN POPULATION - A CROSS SECTIONAL STUDY
Description
Abstract Background: Cognitive impairment poses a significant public health challenge, particularly within aging populations. Early identification is crucial to enable timely intervention and potentially slow progression to dementia. The Mini Mental State Examination (MMSE) is a widely utilized cognitive screening tool but shows limitations in detecting mild cognitive impairment (MCI), especially in culturally diverse populations. The Saint Louis University Mental Status Examination (SLUMS) is suggested as a more sensitive alternative. This study compares the effectiveness of SLUMS and MMSE in identifying cognitive impairment among middle-aged adults in the Indian population. Methods: A cross-sectional study was conducted with 94 middle-aged adults (45–60 years) recruited via purposive sampling from the Department of Physiotherapy, Chhatrapati Shahu Ji Maharaj University, Kanpur. Participants underwent cognitive assessment using both SLUMS and MMSE during the same session. Data normality was evaluated using Shapiro–Wilk and Kolmogorov–Smirnov tests. The Wilcoxon signed-rank test compared scores between the two tools. Agreement was assessed via Cohen’s Kappa and Intraclass Correlation Coefficient (ICC). Sensitivity and specificity of SLUMS were calculated using MMSE as the reference standard. Results: Mean scores for SLUMS (21.79 ± 1.19) and MMSE (21.78 ± 2.25) were statistically comparable (p=0.570). SLUMS identified 98.9% of participants as having mild cognitive impairment, whereas MMSE classified 83% similarly. SLUMS demonstrated 100% sensitivity but low specificity (6.25%) relative to MMSE. Agreement between tools was low (Kappa=0.100, ICC=0.206). Bland–Altman analysis indicated a negligible mean difference (0.01) with acceptable limits of agreement. Conclusion: Both SLUMS and MMSE serve as useful cognitive screening tools; however, SLUMS exhibited higher sensitivity in detecting mild cognitive impairment among the Indian middle-aged population. SLUMS may be better suited for early detection of subtle cognitive deficits. Further research involving larger, diverse populations is warranted to validate these findings. Keywords: Cognitive impairment, SLUMS, MMSE, Mild Cognitive Impairment, Indian population, cognitive screening
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Data were collected from participants using the Saint Louis University Mental Status Examination (SLUMS) and Mini Mental State Examination (MMSE) cognitive assessment tools in a cross-sectional study. The collected scores were entered and organized in IBM SPSS Statistics software for data analysis. Descriptive statistics, including mean, standard deviation, confidence intervals, median, and range, were calculated. Reliability analysis using Cronbach’s Alpha and Intraclass Correlation Coefficient (ICC) was performed to assess agreement between SLUMS and MMSE scores. Sensitivity, specificity, and Receiver Operating Characteristic (ROC) curve analyses were also conducted to evaluate the diagnostic performance of the assessment tools. The uploaded dataset contains the raw and analyzed data used for the study.
Institutions
- Chhatrapati Shahu Ji Maharaj UniversityUttar Pradesh, Kanpur