SHM Converge Scientific Abstract ePoster Gallery-Is Cognitive Testing Culturally Biased? Influence of Language and Literacy.

Pdf Summary

This case describes a 67-year-old man with alcohol use disorder who was hospitalized for alcohol withdrawal after presenting with hallucinations and tremors. Near discharge, occupational therapy administered the Saint Louis University Mental Status Examination (SLUMS) with an Oromo interpreter. He was unable to complete the test, finishing only 18 of 30 items and scoring 3/18 on completed items. Based on this result, OT recommended 24-hour assistance. However, the patient refused placement and inpatient chemical dependency treatment. Using an in-person interpreter, the primary team determined that he had the capacity to make his own decisions.<br /><br />The case highlights important limitations of the SLUMS in non-English speaking, immigrant, and low-literacy patients. SLUMS is intended to screen for dementia and mild neurocognitive disorder, but it was originally studied largely in white outpatient populations, especially at a VA setting. Its inpatient use for discharge planning, capacity assessment, and decision-making in patients from different linguistic and cultural backgrounds may be problematic.<br /><br />The authors emphasize that language barriers, imperfect translation of test items, and differences in educational experience can lower scores even when true cognitive ability is not impaired. This can negatively affect patient care, discharge planning, and perceptions of capacity. The case argues for greater awareness of cultural and linguistic bias in cognitive screening tools and for careful multidisciplinary discussion before using such tests to make major inpatient decisions. The broader goal is to develop cognitive assessment tools that are more valid across cultural, educational, and language differences.

Asset Subtitle

Loretta K. Allotey

Meta Tag

Author List Abhigyan Datta, Benji K. Mathews, Kayla M. Switalla, Loretta K. Allotey, Marissa Paulson, Rachel Marks

Category Clinical Vignettes

Concept Saint Louis University Mental Status Examination

Concept Cognitive Screening Test

Concept Cognitive Test Bias

Concept Cultural Validity

Concept Linguistic Validity

Distinguished Non-Finalist

Presenter Organization University of Minnesota

Presenting Author Loretta K. Allotey

Track Adult

Keywords

alcohol withdrawal

SLUMS

cognitive screening

language barrier

Oromo interpreter

capacity assessment

occupational therapy

low literacy

cultural bias

discharge planning

Saint Louis University Mental Status Examination

Cognitive Screening Test

Cognitive Test Bias

Cultural Validity

Linguistic Validity