title: Picture-based memory impairment screen for dementia.
abstract: OBJECTIVE
  To develop and validate a picture-based memory impairment screen (PMIS) for the detection of dementia.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Outpatient clinics, Baby Memorial Hospital, Kozhikode city in the southern Indian state of Kerala.
  
  
  METHODS
  Three hundred four community-residing adults aged 55 to 94 with a mean education level of 8 years; 65 were diagnosed with dementia.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  The PMIS is a brief and reliable screen for dementia in elderly populations with variable literacy rates.
authors.affiliation: Department of Neurology, Albert Einstein College of Medicine, Bronx, New York 10461, USA. joe.verghese@einstein.yu.edu
authors.forename: Joe
authors.initials: J
authors.lastname: Verghese
authors.forename: Mohan L
authors.initials: ML
authors.lastname: Noone
authors.forename: Beena
authors.initials: B
authors.lastname: Johnson
authors.forename: Anne F
authors.initials: AF
authors.lastname: Ambrose
authors.forename: Cuiling
authors.initials: C
authors.lastname: Wang
authors.forename: Herman
authors.initials: H
authors.lastname: Buschke
authors.forename: Vayyattu G
authors.initials: VG
authors.lastname: Pradeep
authors.forename: Kizhakkaniyakath
authors.initials: K
authors.lastname: Abdul Salam
authors.forename: Kunnukatil S
authors.initials: KS
authors.lastname: Shaji
authors.forename: Pavagada S
authors.initials: PS
authors.lastname: Mathuranath
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003704:Dementia / Q000150:complications* / Q000175:diagnosis*; D003943:Diagnostic Techniques, Neurological; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology*; D010781:Photography; D011446:Prospective Studies