Original Research Article
Year: 2018 | Month: May | Volume: 8 | Issue: 5 | Pages: 226-234
The Development of a New Screening Tool for Cognitive Impairment in India: The Universal Memory and Cognitive Exam (UMACE)
Kardile, Mangal S1; Luscombe, Georgina M2; Peisah, Carmelle3
1“Mental Health Aims”, Nasik, India,
2The School of Rural Health, Sydney Medical School, University of Sydney, New South Wales, Australia,
3University of New South Wales; University of Sydney, Sydney, Australia,
Corresponding Author: Kardile, Mangal S
Background: Screening instruments for cognitive impairment (CI) have been developed in Western settings based on samples with adequate education and literacy. However, it is of prime importance that such screening tools are developed locally, are culturally sensitive and appropriate to populations with lower levels of literacy and education, as are commonly found in less developed countries. The Universal Memory and Cognitive Exam (UMACE) screening tool was developed in India for use in both literate and illiterate populations, and in persons with neurological conditions resulting in disability.
Aims: To assess the psychometric properties of the UMACE in different populations, including non- clinical and clinical adult samples.
Setting and design: The UMACE was administered in three adult samples: a non-clinical sample (n = 78); a sample with or without psychiatric disorders (n = 70) and a sample with and without neurological disorders (n = 207).
Methods: The psychometric properties of the UMACE were examined by administering the 12 item UMACE and the 11 item MMSE.
Statistical analysis: ROC curve analysis assessed the utility of UMACE as a cognitive screen compared with the MMSE.
Results: The UMACE has utility in the detection of cognitive impairment in all samples. In the largest sample (including 20% illiterate subjects) a cut-off of 28.5out of 40 had an AUC 92.5% (95% CI 88.9% to 96.2%)a sensitivity of 89.7% and specificity of 77.0%.
Conclusions: The UMACE is a useful, simple screen for CI appropriate for use in various clinical and non-clinical situations in both literate and illiterate persons.
Key words: cognitive impairment, screening, cognitive testing, literacy, neurological.