Researchers at Montefiore Health System and Albert Einstein College of Medicine have developed the first screening tool to catch early signs of cognitive impairment that accounts for cultural, language and educational differences. According to new research published in the Journal of the American Geriatrics Society, the Picture-Based Memory Impairment Screening (PMIS) can accurately detect cognitive decline in people regardless of their ethnic background or native language. The World Alzheimer Report estimates 28 million of the world's 36 million people with dementia are undiagnosed. The PMIS screening is a tool to reduce that number and increase equality in treatment. “The screening takes about 4 minutes but can give us so much information,” said Rubina Malik, M.D., M.S., first author, co-director at the Montefiore Einstein Center for the Aging Brain and assistant professor of Medicine at Albert Einstein College of Medicine. “What’s critically important is that this new screening tool can be used by primary care practices nationwide to help people of different cultural and ethnic backgrounds receive the care they need faster.” Early detection of cognitive impairment allows time for long term planning and promotes access to clinical trials and medications that may control symptoms. However, current screening methods are often not relevant for non-English speakers or people who lack a formal education. “People shouldn't fall through the cracks just because they grew up in a different country or didn't receive a formal education,” said Joe Verghese, M.B.B.S., director, Montefiore Einstein Center for the Aging Brain, and developer of the PMIS. “With this new screening, our ethnically diverse community can get testing, referrals and support tailored to their backgrounds.” The screening, which is offered at all Montefiore primary care sites, asks people to look at pictures of common items and recall them later in the appointment. It can be administered by nurses or patient technicians, making the screening especially suitable for busy practices. “PMIS gives us insights in real time without judgment,” said Asif Ansari, M.D., regional medical director, Montefiore Medical Group. “The standard tests can be frustrating as they may be time consuming, lack cultural sensitivity or do not take literacy and education level into account. The in-person interaction is a gentle way to make a difference by offering empathy, further care and connections to community based organizations.” To test the accuracy of the PMIS, it was given to 405 patients at Montefiore Einstein Center for the Aging Brain, one of ten New York State funded Centers of Excellence for Alzheimer’s Disease. The results were measured against the standard tool, known as the Blessed Information Memory and Concentration test (BIMC). The PMIS test was more sensitive in detecting cognitive impairment in non-English speakers than the BIMC.