Clinical validity of Fuld Object Memory Evaluation to screen for dementia in a Chinese society.

Objectives: Fuld Object Memory Evaluation (FOME) evaluates the episodic memory functions of encoding, storage, and recall across five recall trials and a delayed recall trial. This study examined the clinical validity of FOME as a screening tool for dementia in older Chinese adults.

Method: The psychometric properties and the discriminative power of FOME were examined in a convenience sample of 192 community-dwelling older individuals, of which 57 were diagnosed with dementia. The influence of age and education on the FOME performance was also estimated.

Results: The test-retest reliability and parallel-form reliability of FOME were excellent, with Intraclass Correlation Coefficients ranging from 0.91-0.96. Good convergent validity of FOME was established with Mini-Mental State Examination (r(p) = 0.69-0.74), and the Memory subscale and the Initiation/Perseveration subscale of Dementia Rating Scale (r(p) = 0.63-0.74). The FOME total retrieval (TR) score and delayed recall (DR) score demonstrated good discriminative power in differentiating dementia from normal cognitive functioning, with area under the curve values of 0.97 and 0.93 respectively. The optimal cut-off scores suggested for TR and DR were 31 (93% sensitivity, 90 specificity) and 7 (91% sensitivity, 82% specificity), respectively. The performance of the FOME was not influenced by the educational level.

Conclusions: The results suggest that the FOME is a reliable and valid instrument to screen for dementia in older community-dwelling Chinese adults. The absence of the effects of education on the assessment performance makes FOME a clinically useful instrument for older adults with limited education.