Picture‐Based Memory Impairment Screen for Dementia

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Abstract
Objectives: To develop and validate a picture‐based memory impairment screen ( PMIS ) for the detection of dementia. Design: Cross‐sectional. Setting: Outpatient clinics, B aby M emorial H ospital, K ozhikode city in the southern I ndian state of K erala. Participants: Three hundred four community‐residing adults aged 55 to 94 with a mean education level of 8 years; 65 were diagnosed with dementia. Measurements: PMIS : a culture‐fair picture‐based cognitive screen designed to be administered by nonspecialists. Diagnostic accuracy estimates (sensitivity, specificity, positive and negative predictive power) of PMIS cut‐scores in detecting dementia (range 0–8). Results: PMIS scores were worse in participants with dementia (1.5) than in controls (7.7, P < .001). At the optimal cut‐score of 5, PMIS had a sensitivity of 95.4% (95% confidence interval ( CI ) = 90.3–100.0%) and a specificity of 99.2% (95% CI = 98.0–100.0%) for detecting dementia. In the 167 participants with <10 years of education, PMIS scores of five or less had a sensitivity of 97.8% (95% CI = 93.6–100.0%) and specificity of 99.2% (95% CI = 97.6–100.0%). The PMIS had better specificity than the M ini‐ M ental S tate E xamination in detecting dementia, especially in older adults with low education. Conclusion: The PMIS is a brief and reliable screen for dementia in elderly populations with variable literacy rates.

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