During a SLUMS test, a clinician spends roughly seven minutes asking a series of short questions and tasks — naming the day and year, remembering five objects, doing simple math, drawing a clock, and recalling a short story. The Saint Louis University Mental Status (SLUMS) exam is an 11-item screening test scored out of 30 points, developed by Saint Louis University with the Geriatric Research, Education and Clinical Center at the St. Louis VA Medical Center, and it is free for clinicians to use.
It is a screening tool, not a diagnosis. A low score tells the doctor that something deserves a closer look; it does not, by itself, mean a person has dementia. Knowing what the items are and how the scoring works can take much of the anxiety out of the appointment, for the person being tested and for the family member sitting beside them.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- The tasks, in the order they usually come
- How the score is read
- How reliable is it compared with other tests?
- Who the test is for — and who it isn't
- How to prepare, and what happens after
- Frequently Asked Questions
The tasks, in the order they usually come
The exam opens with orientation questions: what day of the week it is, what year it is, and what state you are in. The clinician then reads a list of five objects and asks the person to remember them for later — a delayed-recall task that is one of the most sensitive parts of the test. Next come simple mental math items and a verbal fluency task: name as many animals as possible in one minute.
These early items appear on the official SLUMS examination form published by Saint Louis University. The later items shift toward attention, visual-spatial skill, and memory under load. According to the same SLUMS form, the person is asked to: None of the tasks involve equipment beyond pencil and paper, and there is no physical exam component. Per Medical News Today's overview of the SLUMS test, the whole exam typically takes about 7 minutes at the bedside or in a clinic office.
- Repeat strings of numbers backwards (a digit-span task)
- Draw a clock face and set the hands to a stated time
- Identify geometric figures and compare their sizes
- Recall the five objects from earlier in the test
- Listen to a short story read aloud, then answer questions about it
How the score is read
The maximum score is 30, and the cutoffs adjust for education. According to the Shirley Ryan AbilityLab's RehabMeasures summary, for a high-school graduate a score of 27–30 is normal, 21–26 suggests mild neurocognitive disorder, and 1–20 suggests dementia. For someone without a high-school education, the bands shift down: 25–30 normal, 20–24 mild neurocognitive disorder, 1–19 dementia. The education adjustment matters in practice.
A retired engineer who scores 24 lands in the "mild neurocognitive disorder" range; a person with an eighth-grade education scoring 24 falls in the normal range. If you attend an appointment with a family member, make sure the clinician knows their schooling history, because it changes how the same number is interpreted. "Mild neurocognitive disorder" is the clinical term for thinking changes that are measurable but not severe enough to interfere with independent daily life — roughly what many people call mild cognitive impairment. A score in that middle band usually prompts monitoring or further workup, not a dementia diagnosis.
How reliable is it compared with other tests?
The SLUMS was validated in a study of 702 patients at a VA geriatric clinic (Tariq et al., 2006, American Journal of Geriatric Psychiatry). Per the study record on PubMed, it detected dementia about as well as the widely used Mini-Mental State Examination (MMSE) but was better at catching mild neurocognitive disorder that the MMSE missed. That is a meaningful advantage, because early-stage changes are exactly what families most often want assessed. Its reported accuracy is strong for a seven-minute screen.
A summary of the validation data compiled at cgakit.com puts sensitivity around 95% and specificity around 87% for dementia, and about 83% sensitivity with 87% specificity for milder impairment. In plain terms: it flags most people who truly have a problem, while sometimes flagging people who turn out to be fine — which is acceptable for a screen, since abnormal results lead to further evaluation rather than a final verdict. Note that the original validation was done in a VA population, which skews older and male. The test performs well broadly, but no brief screen replaces a full cognitive workup with history, labs, and sometimes imaging.
Who the test is for — and who it isn't
The SLUMS is intended for adults aged 60 and older. Saint Louis University states plainly that it should not be used to assess cognitive problems caused by conditions such as traumatic brain injury, developmental disability, or schizophrenia — those need different tools — and that any abnormal score requires clinical follow-up rather than being treated as a diagnosis.
Expect a trained person on the other side of the table. SLU asks administrators to watch its training video before giving the exam and to review it annually, so this is a clinician-administered test, not a self-quiz to run at home. The exam is available in more than 20 language versions, which matters for accuracy: taking a memory and language test in a second language can artificially lower a score, so ask for the version in the person's strongest language if one exists.
How to prepare, and what happens after
There is no studying for the SLUMS, and coaching a loved one on the items defeats its purpose — an artificially normal score can delay help. Useful preparation is practical: bring glasses and hearing aids, since a missed question due to poor hearing scores the same as a missed question due to memory.
Mention anything that could depress the score temporarily, such as a recent infection, poor sleep, new medications, or depression. If the score is abnormal, the typical next steps are a fuller history from family, bloodwork to rule out reversible causes (thyroid problems, B12 deficiency), medication review, and possibly brain imaging or referral to a memory clinic or neuropsychologist. Because the test is quick and free, clinicians also repeat it over time — a stable 22 across two years tells a different story than a drop from 27 to 22, so keep a record of the date and score from each administration.
Frequently Asked Questions
Can I take the SLUMS test at home by myself?
The form is publicly available, but SLU expects administrators to complete training before giving it, and scoring requires judgment. A self-administered attempt is not a valid result — arrange screening through a clinician.
Is the SLUMS the same as the MMSE or MoCA?
No. All three are brief cognitive screens scored out of 30, but they use different items and cutoffs. In its validation study, the SLUMS matched the MMSE for detecting dementia and outperformed it on milder impairment.
Does a score under 21 mean my parent has dementia?
Not by itself. That range suggests dementia for a high-school graduate, but the result is a screening flag that must be confirmed with a full clinical evaluation, which can also uncover reversible causes.
