Resumen de Picture-Based Memory Impairment Screen for Dementia

Joe Verghese, Mohan Noone, Beena Johnson, Anne F. Ambrose, Cuiling Wang, Herman Buschke, Vayyattu G. Pradeep, Kizhakkaniyakath Abdul Salam, Kunnukatil S. Shaji, Pavagada S. Mathuranath

• Objectives: To develop and validate a picture-based memory impairment screen (PMIS) for the detection of dementia.

  Design: Cross-sectional.

  Setting: Outpatient clinics, Baby Memorial Hospital, Kozhikode city in the southern Indian state of Kerala.

  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 Mini-Mental State Examination 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.