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Validating screening instruments for cognitive impairment in older South Asians in the United Kingdom
1Department of Primary Care & Population Sciences, Royal Free and University College London Medical School, London, UK. g.rait@ucl.ac.uk
Background:
The numbers of older South Asians in the United Kingdom are rising. Investigation of their mental health has been neglected compared to their physical health.
Objectives:
This study aimed to determine the sensitivity and specificity of modified versions of two screening instruments for cognitive impairment (Mini-Mental State Examination and Abbreviated Mental Test) in a community-based population.
Design:
Two-stage study comparing screening instruments against diagnostic interview.
Setting:
South, central and north Manchester.
Subjects:
Community-resident South Asians aged 60 years and over.
Methods:
Subjects were approached via their general practitioners and interviewed at home. Sensitivity and specificity for the screening instruments were calculated using receiver operating characteristic (ROC) curve analysis.
Results:
For the Gujarati population, the MMSE cutoff was >/=24 (sensitivity 100%, specificity 95%) and AMT>/=6 (sensitivity 100%, specificity 95%). For the Pakistani population, the MMSE cutoff was >/=27 (sensitivity 100%, specificity 77%) and AMT>/=7 (sensitivity 100%, specificity 87%).
Conclusions:
Culturally modified versions of the Mini-Mental State Examination and Abbreviated Mental Test are acceptable and may have a high degree of sensitivity. They may assist with the recognition of cognitive impairment, if an appropriate cutoff is used.