In my clinical practice, I frequently encounter patients or their family members who request dementia screening. Our hospital process is luckily very streamlined with a high quality Memory Clinic available to patients who screen positive or still have concerning clinical features. A fully functional dementia clinic run by neurologists and neuropsychologists is likely not available to most community-based primary care providers. So how does a busy primary-care provider screen for dementia? There are many validated screening tools including the Mini-Cog, MoCA, MMSE, SLUMS, and AD8 among others. Here at iMedicalApps we have reviewed a number of geriatrics apps including many from the American Geriatrics Society (AGS) including Geriatrics at Your Fingertips, Multimorbidity/MCC GEMS,iGeriatrics, and AGS GEMS that contain some of these tools. One of the latest apps I reviewed, called AlzDxRx, which helps providers screen, diagnose and manage patients with Alzheimer’s disease, contained several tools including the Mini-Cog. However, it did not contain the SLUMS or MoCa as these are proprietary screening tools. There are dedicated apps available for SLUMS and MoCa and this week we will look at an app called eSLUMS. The app designed by Chewy Logic brings the Saint Louis University Mental Status Exam (SLUMS) created by Dr. Theodore K. Malmstrom and Dr. John Morley to your iOS device.
Evidence based medicine
The app does not contain references for any of its content or references for SLUMS compared to Mini-Cog, MoCA, MMSE, etc. though this info is widely available in other medical references. The SLUMS has a sensitivity/specificity greater than MMSE and on par with the MoCA and Mini-Cog. However, I find the SLUMS more time consuming to complete than the Mini-Cog. The app is essentially a “calculator app” so there is no additional information on what to do with the results, patient management, etc.
What providers would benefit from this App?
Students, residents, mid-levels, Family Medicine, Internal Medicine and subspecialties, and Geriatrics providers. The app could really benefit any provider who sees geriatrics patients and may have to diagnose Alzheimer’s disease.
Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.
- Brings the widely used SLUMS to iOS devices.
- Narration and clock drawing tools work well on mobile device.
- Settings for light dark/location/etc. nice touches.
- No information on evidence for SLUMS compared to other screening tools or references.
- Must pay for PRO features which limits test repeat to weekly.
- Not available for Android.
eSLUMS is a nice addition to the app store that brings a validated dementia screening tool to the point of care. The developers were careful to make the app usable to providers, caretakers, family, etc. The app can be used in combination with apps like AlzDxRx for a more comprehensive dementia evaluation and treatment approach. The app lacks some of the references and evidence I like to see in “calculator” type apps, but you can easily find evidence for the SLUMS on Dynamed Plus, UpToDate, or Essential Evidence Plus.
- Overall Score
- User Interface
Easy to start an assessment on a patient and intuitive with narration option on; clock drawing easier on iPad.
- Multimedia Usage
The app allows sounds/narration to be turned on/off, tracking of scores, clock drawing, but no references of “evidence” provided for the eSLUMS screening test.
Free to download and use, but if you want to use the test more than weekly, track patients, print off copies of tests, etc. must upgrade to Pro version via in-app purchase of $4.99.
- Real World Applicability
eSLUMS is a nice free POC app that brings a useful mental status exam to the iPhone. The score from eSLUMS can be used with apps such as AlzDxRx to aid diagnosing patients with Alzheimer’s disease. One can debate which screening tool to use based on the evidence and ease of use. I will likely stay with the Mini-Cog due to its easy of use.
- Device Used For Review
iPhone 6S running iOS 10.3.3
- Available for DownloadiPhoneiPad