A Picture Is Worth A Thousand Words: Montefiore And Einstein Break Barriers With First Picture-Based Dementia Screening Tool

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 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.

About Montefiore Health System
Montefiore Health System is one of New York's premier academic health systems and is a recognized leader in providing exceptional quality and personalized, accountable care to approximately three million people in communities across the Bronx, Westchester and the Hudson Valley. It is comprised of 11 hospitals, including the Children's Hospital at Montefiore, Burke Rehabilitation Hospital and close to 200 outpatient care sites. The advanced clinical and translational research at its medical school, Albert Einstein College of Medicine, directly informs patient care and improves outcomes. From the Montefiore-Einstein Centers of Excellence in cancer, cardiology and vascular care, pediatrics, and transplantation, to its preeminent school-based health program, Montefiore is a fully integrated healthcare delivery system providing coordinated, comprehensive care to patients and their families. For more information, please visit www.montefiore.org. Follow us on Twitter and view us on Facebook and YouTube.

About the Montefiore Hudson Valley Center of Excellence for Alzheimer's Disease
The Montefiore Hudson Valley Center of Excellence for Alzheimer's Disease (CEAD) combines the years of expertise and best-in-class practices of the Montefiore-Einstein Center for the Aging Brain (CAB); Burke Rehabilitation Hospital's Memory Evaluation and Treatment Service (METS); an expanding network of hospitals and physician groups in the Hudson Valley; and the research and training capabilities of Montefiore's Albert Einstein College of Medicine. The CEAD is one of ten Alzheimer's Disease Centers of Excellence supported in part by a grant from the New York State Department of Health in an ambitious program to: expand knowledge about Alzheimer's Disease and related dementias; improve access to screening, diagnosis and clinical trial opportunities for individuals; ensure that patients and their caregivers are referred to community-based support services; and conduct training programs in dementia diagnosis and care for physicians and health care professions students in all clinical disciplines. For more information, please visit www.montefiore.org/alzheimers-center.

About Albert Einstein College of Medicine
Albert Einstein College of Medicine, part of Montefiore, is one of the nation's premier centers for research, medical education and clinical investigation. During the 2017-2018 academic year, Einstein is home to 697 M.D. students, 181 Ph.D. students, 108 students in the combined M.D./Ph.D. program, and 265 postdoctoral research fellows. The College of Medicine has more than 1,900 full-time faculty members located on the main campus and at its clinical affiliates. In 2017, Einstein received more than $174 million in awards from the National Institutes of Health (NIH). This includes the funding of major research centers at Einstein in aging, intellectual development disorders, diabetes, cancer, clinical and translational research, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Its partnership with Montefiore, the University Hospital and academic medical center for Einstein, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. Einstein runs one of the largest residency and fellowship training programs in the medical and dental professions in the United States through Montefiore and an affiliation network involving hospitals and medical centers in the Bronx, Brooklyn and on Long Island. For more information, please visit www.einstein.yu.edu, read our blog, follow us on Twitter, like us on Facebook, and view us on YouTube.