Hindi Mental State Examination (HMSE) as a screening test for illiterate demented patients

Dementia is an unbearable illness affecting mainly the elderly. The most common screening tool for the evaluation of dementia is the MMSE (Mini Mental State Examination). Unfortunately this test demands for an education of higher than 4 years. The developing countries have a large number of elderly people who are illiterate, the same as in our country. The HMSE (Hindi Mental State Examination), a test addressed to people who are illiterate, is intended only to screen individuals and populations for cognitive impairment and not for diagnostic purposes. It is a tool developed by the IndoUS Cross-National Dementia Epidemiology Study, composed by 22 items which examine various cognitive capacities (orientation to time and place, memory, attention, concentration, recognition of objects, language function, comprehension and expressive speech, motor functioning and praxis). The total score if all items are answered is 30 as in MMSE. One hundred illiterate people, 50 healthy elderly non-demented and 50 patients with Alzheimer's Disease were examined with the HMSE in our Memory and Dementia Outpatient Clinic. The t-test was used for the statistical analysis. It was found that in the healthy elderly the mean score of the test was 26,382,23 and in demented patients it was 9,787,24 (t=15.477). The difference was statistically significant (p<0,001). The cut off was 23 (sensitivity 94%, specificity 98%). The test was simple and rapidly administered, so it is introduced to be used as a screening test for illiterate elderly people.

Key words: Screening, Dementia, Illiterate people.