Picture-based memory impairment screen for dementia

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

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)2116-2120
Number of pages5
JournalJournal of the American Geriatrics Society
Issue number11
StatePublished - Nov 2012


  • Alzheimer's disease
  • dementia
  • diagnosis
  • primary care
  • sensitivity
  • specificity

ASJC Scopus subject areas

  • Geriatrics and Gerontology


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