Cognitive Deficit Reversal as Shown by Changes in the Veterans Affairs Saint Louis University Mental Status (SLUMS) Examination Scores 7.5 Years Later
Cognitive Deficit Reversal as Shown by Changes in the Veterans Affairs Saint Louis University Mental Status (SLUMS) Examination Scores 7.5 Years Later
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DOI：
10.1016/j.jamda.2014.05.004
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发表时间：
2014-09-01
影响因子：
7.6
通讯作者：
Grossberg, George T.
中科院分区：
文献类型：
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作者：
Cruz-Oliver, Dulce M.;Malmstrom, Theodore K.;Grossberg, George T.
目的：退伍军人事务部圣刘易斯大学精神状态（SLUMS）检查是一种筛查工具，具有检测轻度神经认知障碍和痴呆的灵敏度。本研究根据7.5年后SLUMS检查评分的变化探讨患者的认知障碍轨迹。设计：回顾性病历回顾。设置：退伍军人事务部医疗中心（VAMC）老年研究、教育和临床中心，圣刘易斯，MO。参与者：对533份病历的回顾表明，2003年参加SLUMS检查验证研究的357名患者仍然活着。图表进行筛选的认知状态指标在2003年和2010年和干预后基线evaluation.Results：在2003年的357个人的平均年龄为74岁，所有的男性，73%的高中以上教育。357例患者中共有223例（62%）在基线和7.5年随访访视时完成了SLUMS检查;其中33例（15%）进展为轻度认知缺陷，20例（9%）进展为重度认知缺陷，53例（24%）改善或恢复正常。进一步探索显示，大多数（n = 36/53，68%）逆转至少有一个可逆的原因。主要的干预措施，从nonreversers的逆转是矫正视力下降（P = 0.005）和抗胆碱能药物的停药（P = 0.002）。结论：认知改善（逆转）所示的SLUMS检查后7.5年与纠正一些可逆的原因。这强调了早期发现和排除可逆原因的重要性，对使用SLUMS检查筛查认知功能障碍的人。(C)2014年AMDA -急性后和长期护理医学协会。
Objective: The Veterans Affairs Saint Louis University Mental Status (SLUMS) examination is a screening tool that has the sensitivity to detect mild neurocognitive impairment and dementia. This study explores patients' cognitive impairment trajectories based on the SLUMS examination score changes after 7.5 years.Design: Retrospective chart review.Setting: The Geriatric Research, Education, and Clinical Center at the Department of Veterans Affairs Medical Center (VAMC), St Louis, MO.Participants: A review of 533 charts indicated that 357 patients who had participated in the SLUMS examination validation study in 2003 were still alive.Measurement: Charts were screened for indicators of cognitive status in both 2003 and 2010 and interventions after baseline evaluation.Results: The mean age of the 357 individuals in 2003 was 74, all were men, and 73% had a high school education or more. A total of 223 (62%) of the 357 completed the SLUMS examination at baseline and at the 7.5-year follow-up visit; of those, 33 (15%) progressed to mild cognitive deficit, 20 (9%) progressed to severe cognitive deficit, and 53 (24%) improved or reverted back to normal. Further exploration revealed that at least one reversible cause was identified for most (n = 36/53, 68%) of the reversions. The primary interventions that differentiated reversers from nonreversers were correction of visual loss (P = .005) and discontinuation of anticholinergic medications (P = .002).Conclusion: Cognitive improvement (reversion) as indicated by the SLUMS examination after 7.5 years was associated with the correction of some reversible causes. This stresses the importance of early detection and exclusion of reversible causes for persons screened for cognitive dysfunction using the SLUMS examination. (C) 2014 AMDA - The Society for Post-Acute and Long-Term Care Medicine.