title: Development and validation of the Pictorial Cognitive Screening Inventory for illiterate people with dementia.
abstract: OBJECTIVE
  The purpose of this study was to develop and validate a tool called the Pictorial Cognitive Screening Inventory (PCSI), which consists of pictorial memory and attention tests that are not influenced by literacy level.
  
  
  METHODS
  PCSI, Mini Mental State Examination (MMSE), and Clinical Dementia Rating (CDR) questionnaires were administered to 80 elderly participants (20 illiterate normal, 20 illiterate with dementia, 20 literate normal, and 20 literate with dementia).
  
  
  RESULTS
  PCSI scores were highly correlated with those of the MMSE (r 0.51) and the CDR (r -0.71). In addition, the PCSI scores differed significantly between the normal group and the dementia group (mean difference 1.71, standard error [SE] 0.14, P<0.001), while no such difference was observed between the illiterate group and the literate group (mean difference 0.00, SE 0.24, P=0.997). Diagnostic validity of the PCSI is excellent, with a sensitivity of 90% and a specificity of 98% for screening dementia, whereas the MMSE has a sensitivity of 85% and a specificity of 60%.
  
  
  CONCLUSIONS
  These results indicate that the PCSI is a sensitive and reliable test for screening dementia, regardless of an individual's literacy skills. The PCSI meets the increasing needs for screening of dementia in illiterate elderly populations in developing countries.
authors.affiliation: Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Soowon
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Se-Eun
authors.initials: SE
authors.lastname: Park
authors.affiliation: Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Min-Ji
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea ; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hee-Yeon
authors.initials: HY
authors.lastname: Jung
authors.affiliation: Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea ; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jung-Seok
authors.initials: JS
authors.lastname: Choi
authors.affiliation: Department of Psychology, The Catholic University of Korea, Bucheon, Republic of Korea.
authors.forename: Kee-Hwan
authors.initials: KH
authors.lastname: Park
authors.affiliation: Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Inhye
authors.initials: I
authors.lastname: Kim
authors.affiliation: Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea ; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jun-Young
authors.initials: JY
authors.lastname: Lee
keywords: cognition; dementia; literacy; screening