Validating screening instruments for cognitive impairment in older South Asians in the United Kingdom

Background. The numbers of older South Asians in the United kingdom are ris ing. Investigation of their mental health has been neglected compared to th eir physical health. Objectives. This study aimed to determine the sensitivity and specificity o f modified versions of two screening instruments for cognitive impairment ( Mini-Mental State Examination and Abbreviated Mental Test) in a community-b ased 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 inter viewed at home. Sensitivity and specificity for the screening instruments w ere calculated using receiver operating characteristic (ROC) curve analysis . Results. For the Gujarati population, the MMSE cutoff was greater than or e qual to 24 (sensitivity 100%, specificity 95 %) and AMT greater than or equ al to 6 (sensitivity 100%, specificity 95%). For the Pakistani population, the MMSE cutoff was greater than or equal to 27 (sensitivity 100%, specific ity 77%) and AMT greater than or equal to 7 (sensitivity 100%, specificity 87%). Conclusions. Culturally modified versions of the Mini-Mental State Examinat ion and Abbreviated Mental Test are acceptable and may have a high degree o f sensitivity. They may assist with the recognition of cognitive impairment , if an appropriate cutoff is used. Copyright (C) 2000 John Wiley & Sons, L td.