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27PICTURE-BASED MEMORY IMPAIRMENT SCREEN FOR DEMENTIA: INFLUENCE OF ETHNICITY AND EDUCATION LEVEL AMONG THE ELDERLY IN MALAYSIA

Introduction: Differences in linguistic properties, literacy level, and cultural acceptance may cause difficulties and are known as major limitation factors in identifying dementia in developing countries where the greatest increase in prevalence of dementia is expected to be seen. This study aimed to investigate the influence of multi-ethnicity and education level on Picture-based Memory Impairment Screen (PMIS) among elderly in Malaysia. Methods: The PMIS, Identification and Intervention for Dementia in Elderly Africans (IDEA) cognitive screen and Mini Mental State Examination (MMSE) were administered to a convenience sample of elderly individuals (≥60years) from the community and outpatient clinics at the University of Malaya Medical Centre, Kuala Lumpur, Malaysia. Consensus diagnosis was performed by two geriatricians blinded to PMIS scores using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) clinical criteria. Results: A total of 564 participants were recruited with median (interquartile range, IQR) age of 71.5 (67-83) and median years of education 11.0 (9-13). About 317 (55.4%) were female and 255 (44.6%) were male. The majority were Chinese (n=361, 63.1) followed by Indian (n=133, 23.3%) and Malay and Others (n=78,13.6%). Based on DSM-V classification among 75 randomly selected individuals, participants with major neurocognitive disorder (n=33, 64%) (T-test, p<0.05) showed poorer performance in PMIS compared to those with no neurocognitive disorder (n=42, 56%). In univariate analyses, fewer years of education and differences in ethnicity were non-significant (Kruskal-wallis test, p>0.05). After adjustment for DSM-V classification in multivariable logistic regression, fewer years of education and differences in ethnicity remain insignificantly (p>0.05) different in performance of PMIS. Conclusions: PMIS performance showed no influence on ethnicity and education level among our elderly. This study may give options for healthcare providers on available screening tools that consider cultural and educational factors in screening dementia.