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MPS251: PSYCHODIAGNOSTIC LAB 1
CIA - II
POST GRADUATE INSTITUTE MEMORY SCALE (PGIMS)
REPORT
Submitted by
Pari Anand 24223038
Submitted to
prof. Saswati Bhattacharya
March 15, 2025
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Practical 2
Post Graduate Institute Memory Scale (PGIMS)
Memory is described as "how individuals utilize past experiences to inform present
actions" (Sternberg, 1999). It encompasses the psychological mechanisms of acquiring, storing,
retaining, and retrieving information, involving three primary stages: encoding, storage, and
retrieval. Memory facilitates both the preservation and recovery of information, though it is
susceptible to errors. Impairments in memory can range from minor lapses, such as forgetting
birthdays, to severe conditions like Alzheimer's disease and other forms of dementia, which
significantly impact quality of life and functional abilities.
Memory is categorized into three primary types: sensory memory, short-term memory
(STM), and long-term memory (LTM). Sensory memory serves as a transient system that
processes sensory input, acting as the initial phase of memory processing. Short-term memory,
often equated with working memory, is responsible for temporarily storing and manipulating
information. In contrast, long-term memory manages the prolonged storage of information, with
a vast capacity and duration that can span from hours to a lifetime, encompassing knowledge,
skills, and experiences.
Neurocognitive disorders
Neurocognitive disorders (NCDs) encompass a group of conditions characterized by
significant cognitive decline that is acquired rather than developmental. These disorders affect
cognitive domains such as memory, attention, executive function, language, perceptual-motor
abilities, and social cognition. The onset of NCDs represents a decline from a previously attained
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level of functioning and is linked to various underlying medical conditions or neurological
diseases.
The spectrum of NCDs, as defined in the DSM-5, begins with delirium, followed by 3
major and mild neurocognitive disorders.
The major and mild NCD subtypes include:
● Neurocognitive disorder due to Alzheimer’s disease – The most common cause of
dementia, characterized by progressive memory loss and cognitive decline.
● Vascular Neurocognitive disorder– Resulting from cerebrovascular events leading to
cognitive impairment.
● Neurocognitive disorder with Lewy bodies – Marked by fluctuating cognition, visual
hallucinations, and Parkinsonian symptoms.
● Neurocognitive disorder due to Parkinson’s disease – Cognitive decline associated with
Parkinson’s pathology.
● Frontotemporal Neurocognitive disorder – Characterized by changes in behavior,
personality, and language deficits.
● Neurocognitive disorder due to traumatic brain injury (TBI) – Resulting from head
trauma with varying cognitive effects.
● Neurocognitive disorder due to HIV infection – Cognitive impairment associated with
HIV-related neurodegeneration.
● Substance/medication-induced Neurocognitive disorder – Caused by prolonged substance
use or exposure to neurotoxic medications.
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● Neurocognitive disorder due to Huntington’s disease – A genetic disorder leading to
cognitive, motor, and psychiatric symptoms.
● Neurocognitive disorder due to prion disease – A rapidly progressive condition, including
Creutzfeldt-Jakob disease.
● Neurocognitive disorder due to another medical condition – Cognitive impairment 4
resulting from systemic or neurological diseases.
● Neurocognitive disorder due to multiple etiologies – Cognitive decline resulting from a
combination of factors.
● Unspecified Neurocognitive disorder – Cognitive impairment that does not fit into
established subtypes.
Prevalence in India
According to the Global Burden of Disease Study (GBDS) 2019, the number of dementia
cases is projected to increase by 166% between 2019 and 2050, affecting approximately 152.8
million individuals, similar to estimates by the WHO. This rise is expected to be most significant
in countries like India, with an increase of up to 330%, primarily due to its low ranking on the
Socio-demographic Index (SDI) (Nichols et al., 2022).
In 2019, India was the fourth-largest contributor to the global burden of dementia and is
expected to surpass Japan and the USA by 2050. The prevalence of mild and major
neurocognitive disorders in the population is 17.6% and 7.2%, respectively.
Clinical Picture
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Memory impairments are common in neurological disorders like Alzheimer’s, vascular
dementia, Parkinson’s, traumatic brain injury, stroke, and epilepsy. These conditions affect brain
areas crucial for memory, leading to deficits in short-term and long-term recall, attention, and
information retention.Major NCDs involve significant cognitive impairment that interferes with
independence in everyday activities, while mild NCDs represent a more modest cognitive
decline that does not significantly hinder daily functioning but may require compensatory 5
strategies.
Diagnostic Criteria
Major Neurocognitive Disorder
A. Evidence of significant cognitive decline from a previous level of performance in one or
more cognitive domains (complex attention, executive function, learning and memory,
language, perceptual-motor, or social cognition) based on:
1. Concern of the individual, a knowledgeable informant, or the clinician that there
has been a significant decline in cognitive function; and
2. A substantial impairment in cognitive performance, preferably documented by
standardized neuropsychological testing or, in its absence, another quantified
clinical assessment.
B. The cognitive deficits interfere with independence in everyday activities (i.e., at a
minimum, requiring assistance with complex instrumental activities of daily living such
as paying bills or managing medications).
C. The cognitive deficits do not occur exclusively in the context of a delirium.
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D. The cognitive deficits are not better explained by another mental disorder (e.g., major
depressive disorder, schizophrenia).
Specify (see coding table for details):
Without behavioral disturbance: If the cognitive disturbance is not accompanied by
any clinically significant behavioral disturbance.
With behavioral disturbance (specify disturbance): If the cognitive disturbance 6 is
accompanied by a clinically significant behavioral disturbance (e.g., psychotic symptoms,
mood disturbance, agitation, apathy, or other behavioral symptoms).
Specify current severity:
Mild: Difficulties with instrumental activities of daily living (e.g., housework, managing
money).
Moderate: Difficulties with basic activities of daily living (e.g., feeding, dressing).
Severe: Fully dependent.
Mild Neurocognitive Disorder
A. Evidence of modest cognitive decline from a previous level of performance in one or
more cognitive domains (complex attention, executive function, learning and memory,
language, perceptual-motor, or social cognition) based on:
1. Concern of the individual, a knowledgeable informant, or the clinician that there
has been a mild decline in cognitive function; and.
2. A modest impairment in cognitive performance, preferably documented by
standardized neuropsychological testing or, in its absence, another quantified
clinical assessment.
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B. The cognitive deficits do not interfere with capacity for independence in everyday
activities (i.e., complex instrumental activities of daily living such as paying bills or
managing medications are preserved, but greater effort, compensatory strategies, or
accommodation may be required).
C. The cognitive deficits do not occur exclusively in the context of a delirium.
D. The cognitive deficits are not better explained by another mental disorder (e.g., major
depressive disorder, schizophrenia).
Specify (behavioral disturbance cannot be coded but should still be recorded):
Without behavioral disturbance: If the cognitive disturbance is not accompanied by
any clinically significant behavioral disturbance.
With behavioral disturbance (specify disturbance): If the cognitive disturbance is
accompanied by a clinically significant behavioral disturbance (e.g., psychotic symptoms,
mood disturbance, agitation, apathy, or other behavioral symptoms).
Need for Assessment
Memory plays a very crucial role in our day to day lives by allowing us to learn, make
judgments, and navigate the world around us. Evaluating memory functions is crucial to
understand cognitive abilities and to identify deficits that can interfere with our everyday life.
The Post Graduate Institute Memory scale (PGIMS) is an essential tool for assessing an
individual’s memory functions including efficient encoding, storage and retrieval and identifying
possible deficits in cognitive processing.
PGIMS is helpful in evaluating people with neurological or psychiatric disorders, brain
injuries, and cognitive decline. It makes it easier to differentiate between different kinds of
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memory deficits and comprehend the underlying reasons for them. Furthermore, regular
evaluation using PGIMS helps in monitoring changes in cognition over time, tracking the course
of the disease, and assessing the efficacy of treatment.
PGIMS assists clinicians in identifying memory-related problems and creating 8
individualized intervention plans by offering a thorough and impartial assessment. This
guarantees improved cognitive health management, which eventually raises a person's standard
of living overall.
Available Assessment Measure
Mini-Mental State Examination (MMSE)
Developed by Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975).The MMSE is a
brief cognitive screening tool that assesses orientation, attention, memory, language, and
visuospatial abilities. It evaluates short-term memory, long-term memory, language (e.g.,
naming, repetition), and orientation (e.g., date, place).Commonly used to screen for cognitive
impairment in older adults, particularly for Alzheimer's disease and other dementias.
Wechsler Memory Scale (WMS)
The Wechsler Memory Scale (WMS), developed by David Wechsler in 1945, is a
comprehensive tool designed to measure various aspects of memory, including immediate recall,
delayed recall, visual and verbal memory, and working memory. It is particularly useful in
assessing memory deficits in individuals with dementia, traumatic brain injury, stroke, and other
neurological conditions.
Frontal Assessment Battery (FAB)
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The Frontal Assessment Battery (FAB), developed by Dubois et al. in 2000, evaluates
executive functions such as planning, mental flexibility, inhibition, and verbal fluency, which are
crucial to memory. It is commonly used to assess individuals with Parkinson’s disease,
frontotemporal dementia, and other conditions that affect executive function.
Memory Assessment Scale (MAS)
The Memory Assessment Scale (MAS), developed by Woods and colleagues in 1992, is
another important tool used to assess various aspects of memory functioning. This scale is
primarily designed to evaluate memory impairment in older adults, particularly those with
dementia or memory-related disorders. The MAS includes both subjective and objective
assessments, allowing it to measure different dimensions of memory, such as short-term memory,
long-term memory, verbal memory, and visual memory.
Recognizing the need for a brief, objective, and reliable memory assessment, Indian
psychiatrists, neurologists, and clinical psychologists developed the P.G.I. Memory Scale.
Standardized by Dwarka Prasad and N.N. Wig in 1977, this scale serves as a crucial tool for
evaluating memory function in clinical settings. By assessing various aspects of memory,
including retention, recall, and recognition, the P.G.I. Memory Scale aids professionals in
diagnosing and managing cognitive impairments effectively.
Postgraduate Institute Memory Scale (PGIMS)
Background
The Postgraduate Institute Memory Scale (PGIMS) was developed at the Postgraduate
Institute of Medical Education and Research (PGIMER) in Chandigarh, India. Dwarka Prasad
and N.N. Wig developed the scale in 1977. This is a comprehensive scale that is designed to
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measure the verbal and non-verbal memory. The construction of memory scale efforts were made
to ensure that it was not unduly dependent on intelligence and was equally valid for both sexes
and applicable and acceptable to illiterate and unsophisticated subjects who constituted the
majority of subjects in Indian hospitals and clinics.
The scale was validated against four hypotheses– that (1) the subjects suffering from 10
neurological disorders would obtain poorer scores that the subjects suffering from the functional
psychiatric illness, (2) the older subjects should obtain lower scores than younger normal adults,
(3) the scores on memory scale should have a positive relationship with education, and (4) it
should not have high correlation with intelligence test scores.
The PGIMS has become a popular memory scale throughout India and replaced the
Boston Memory Scale and Wechsler Memory Scale at both the premier institutes of psychiatry
i.e., National Institute of Mental Health and Neuro Sciences, Bangalore and Central Institute of
Psychiatry, Ranchi.
Description of the test
The PGIMS measures verbal and non-verbal memory; it contains 10 sub-tests –
- Remote memory
- Recent memory
- Mental balance
- Attention concentration
- Delayed recall
- Immediate recall (sequential reproduction of sentences)
- Retention of similar pairs
- Retention of dissimilar pairs
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- Visual retention
- Recognition
PGIMS consists of 64 items distributed across its 10 subtests, which measure various
aspects of memory. It is for people who are 20 years of age or older.
Reliability
The reliability of the scale was tested by repeating the scale after an interval of one week,
for this the test was re-administered on 40 subjects after an interval of one week. The test- retest
reliability ranged between -70 and .84 for organic psychotic groups, and .48 to .84 for
neurotic-normal groups. Split-half reliability was found to be .91 and .83 (Pershad, D., & Wig,
N. N, 1977).
Validity
PGIMS was found to have a correlation of .71 with the Boston memory scale and .85
with the Wechsler memory scale. It also confirmed the four hypotheses set to demonstrate its
validity (Pershad, D., & Wig, N. N,1977).
Administration
The PGIMS (Post Graduate Institute Memory Scale) measures various memory domains
and can be administered to individuals aged between 20 and 80 years.
Instructions
During the administration of the test, specific instructions were provided to the
respondent to ensure accuracy and reliability. The respondent was instructed to listen carefully,
seek clarifications before starting, and maintain focus throughout the test. They were informed
that there were no right or wrong answers and encouraged to respond to the best of their ability.
The respondent received the necessary materials like paper, a pencil, and an eraser. Instructions
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were delivered clearly to ensure comprehension, and the test was conducted under standard
conditions to maintain consistency.
Procedure
The individual shall be seated in a comfortable, well-lit environment. A friendly 12
conversation can be initiated to make the individual feel at ease in the room and ensure a rapport
formation. The test's purpose and instructions should be communicated to the individual.
Informed consent must be obtained. A simple language that is well understood by the individual
should be used. The tester should clarify all the doubts.
Precautions
Firstly, the instructions to the respondent were given in simple and understandable
language. Secondly, the respondents were seated in a well-lit, ventilated environment. Thirdly,
adherence to standardized administration procedures was necessary to maintain the validity and
reliability of the test. Lastly, the intervals and the total time taken were noted appropriately.
Scoring
In Sub-test I and II, participants receive 1 score for each correct response. For Sub-test
III, different scoring criteria apply based on the task. In the alphabet and counting backward
tasks, 3 scores are awarded if all responses are correct within 15 seconds, 2 scores if it takes
longer than 15 seconds, 1 score if there is 1 mistake or omission, and 0 scores if there are two or
more mistakes or omissions. For counting backward by 3s, 3 scores are given if all responses are
correct within 30 seconds, 2 scores if it takes longer than 30 seconds but all responses are
correct, 1 score if there is 1 mistake or omission, and 0 scores if there are two or more mistakes
or omissions. The maximum possible score for this sub-test is 3+3+3=9.
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The Sub-test IV consists of two sections: Digits Forward and Digits Backward. In Digits
Forward, scoring is based on the number of digits correctly recalled in sequence. For 3 and
4-digit sequences, participants earn 1 score for correctly repeating all digits. For 5 and 6-digit
sequences, they receive 2 scores for perfect recall and 1 score if they make 1 mistake and 0 score
for 2 or more mistakes. In the case of 7 and 8-digit sequences, 3 scores are awarded for correctly
repeating all digits, 2 scores for 1 mistake, and 0 scores for 2 or more mistakes. The maximum
possible score for this section is 12.
In Digits Backward, participants must recall the digits in reverse order. For 2 and 3-digit
sequences, 1 score is given for correctly repeating all digits in reverse. For 4 and 5-digit
sequences, 2 scores are awarded for perfect recall, and 1 score is given for 1 mistake and 0 for 2
or more mistakes. For 6 and 7-digit sequences, 3 scores are awarded for perfect recall, 2 scores
for 1 mistake, and 1 score for 2 mistakes and 0 for 3 or more mistakes. For 8-digit sequences, 4
scores are given for a perfect recall, 3 scores for 1 mistake, and 2 scores for 2 mistakes and 0 for
3 or more mistakes. The maximum possible score for this section is 16. Thus, the total maximum
possible score for subtest IV (Digits Forward and Digits Backward) is 12 + 16 = 28.
In subtest V, participants receive 1 score for each correctly recalled word. The total
maximum possible score for this sub-test is 10. For sub-test VI, participants are given 1 score for
each correctly reproduced clause. The total maximum possible score for this sub-test is 12. For
subset VII, participants are awarded 1 score for each correctly reproduced associated word of the
pair. The total maximum possible score for this sub-test is 5. For subtest VIII. participants
receive 1 score for each correctly reproduced pair separately. A maximum of three trials is
allowed. The total maximum possible score for each trial is 5, and the sum of all three trials
results in a maximum score of 15 (5+5+5=15).
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In Sub-test IX, participants are scored based on the correct reproduction of geometrical
figures in sequence and number. For Cards 1 to 3, they receive 2 scores each, totaling 6 scores
(2+2+2 = 6). For Card 4, 3 scores are awarded, and for Card 5, 4 scores are given. This results in
a total maximum possible score of 13 for this sub-test. In Sub-test X, participants earn 1 score for
each correctly recognized and named object. However, 1 score is deducted for each incorrectly
14 identified objects from the total earned score.
The total maximum possible score for this sub-test is 10. The total maximum possible
score for the full test is 114 (8+ 5 + 9 + 12 + 16 + 10 + 12 + 5 + 15 + 13 + 10 = 115).
Interpretation
The next step in the assessment process involves interpreting the scores for each sub-test
using the percentile norm table for individuals aged 20 to 45 years. Each sub-test score will be
compared against the established percentile ranges to determine the participant's performance
level.
Additionally, the grand total score will be evaluated to provide an overall assessment of
the participant’s memory abilities. The percentile range obtained from the total score will then be
used to classify the participant’s memory level, based on the norms for interpretation of
percentiles table. This step ensures a standardized evaluation of memory functioning relative to
the normative population.
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Clinical Application of the Test
Research has demonstrated that the PGIMS effectively differentiates between normal and
impaired memory performance across various clinical groups, such as neurotic, psychotic, and
organic cases, thereby helping clinicians identify memory deficits and building treatment
strategies (Persad & Wig, 1978). It helps in diagnosing memory impairments related to
neurological conditions like dementia, traumatic brain injuries, and stroke. It is also useful in
evaluating cognitive decline in aging populations and individuals with neurodegenerative
disorders such as Alzheimer's disease. Its reliability and validity make it a crucial instrument in
neurocognitive assessments, contributing significantly to monitoring cognitive disorders over
time (Pershad & Wig, 1978). The scale has huge relevance to the Indian context as it was made
without the influence of any foreign methods of assessment and generalised on the Indian
population.
Methodology
Client profile
Name: B.A.
Age: 45
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Sex: Female
Date of birth: 15/2/1980
Education: Postgraduate
Occupation: Housewife
Marital status: Married
Administration
The PGI Memory Scale is a comprehensive instrument that is intended to measure several
aspects of memory, such as remote, recent, immediate, and visual memory, as well as attention
and concentration. The test takes about 25–30 minutes to administer, depending on the pace and
response time of the participant. Each subtest has a standardized procedure, with clear
instructions given to ensure reliability and consistency. The examiner should use a neutral tone,
refrain from providing feedback on responses, and provide a quiet testing environment.
Results
Table 1.
Raw scores, percentile range and interpretation of the scores
Sr. No. Subtest Name Raw Scores Percentile Range interpretation
I. Remote Memory 8 P80 - P100 Excellent Memory
II. Recent Memory 5 P40 - P60 Average/ Moderate
Memory
III, Mental Balance 9 P60 - P80 Above Average Memory
IV. Attention and 22 P60 - P80 Above Average Memory
Concentration
V. Delayed Recall 8 P20 - P40 Below Average Memory
VI. Immediate Recall 9 P40 - P60 Average/ Moderate
Memory
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VII. Verbal Retention for 5 P40 - P60 Average/ Moderate
similar pairs Memory
VIII. Verbal Retention for 14 P60 - P80 Above Average Memory
dissimilar pairs
IX. Visual Retention 13 P80 - P100 Excellent Memory
X. Recognition 10 P60 - P80 Above Average Memory
Total 103 P80 - P100 Excellent Memory
Scores
Interpretation
Remote memory (subtest I)
The client received a raw score of 8, which falls within the range of 80th to 100th
percentile, showing an excellent remote memory. This indicates that the client possesses good
retrieval and recall skills of past situations and long term preserved information. Her memory of
past experiences, facts, and history is preserved well, thus demonstrating good long-term
memory storage and retrieval.
Recent Memory (subtest II)
A raw score of 5 was attained by the client in this dimension, this raw score falls within
the range of 40th to 60th percentile, indicating that the client has an average/moderately average
recent memory. This implies that even though the client remembers things from the recent past,
for instance, discussions, activities, or tasks from the last few days or weeks, there are occasional
challenges to remember or recall things.
Mental Balance (subtest III)
The client attained a score of 9 on this particular subtest, indicating that the client has
above average mental balance, belonging to the percentile range of 60th to 80th. This implies
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that the client has good cognitive stability, concentration and control over her thoughts. She has a
good ability to switch between cognitive tasks.
Attention and Concentration (subtest IV)
The client recorded a raw score of 22 on this particular dimension, placing it in the 60th
to 80th percentile, representing above-average attention and concentration. This indicates that the
client has an excellent capability for concentrating on tasks, maintaining attention, and
eliminating distractions. Although concentration ability is highly developed, there might be rare
slips in attention, particularly in extended or extremely intricate tasks.
Delayed Recall (subtest V)
The client received a raw score of 8, which puts them in the 20th to 40th percentile,
indicating a below average delayed recall. This implies that the client has difficulties in retaining
and remembering information after a gap. This may affect her ability to recall information after a
delay.
Immediate Recall (subtest VI)
The client’s raw score was 9 on this subtest, which falls in the 40th to 60th percentile,
indicating average or moderate immediate recall. This subtest measures the capacity to store and
reproduce information immediately after it has been presented. The obtained score implies that
she can reproduce information immediately after hearing it but might have occasional difficulty.
Verbal Retention for Similar Pairs (subtest VII)
The client received a raw score of 5 on this subtest, falling within the range of 40th to
60th percentile, reflecting average verbal retention for similar pairs. This subtest assesses the
capacity to recall word pairs that have semantic similarities. The scores imply that the client can
remember the paired information moderately but may have a few lapses,
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Verbal Retention for Dissimilar Pairs (subtest VIII)
The client scored a raw score of 14 on this subtest, ranging within the range of 60th to
80th percentile, signifying above average recall for dissimilar pairs. An above average score on
this particular subtest indicates that the client has a good capacity to make significant
associations between apparently disparate information, a skill needed in problem-solving,
analytical reasoning, and creative reasoning.
Visual Retention (subtest IX)
The client scored a raw score of 13 on this subtest, falling in the 80th to 100th percentile,
which reflects excellent visual retention. This subtest tests the capacity to recall and remember
visual patterns, symbols, or shapes. Scoring high in this domain suggests good visual memory
skills, which are essential for spatial thinking, navigation, and face or object recognition. This 37
ability is especially useful for activities that need pattern recognition, visual learning, and rapid
recall of diagrams or images.
Recognition (subtest X)
The client received a raw score of 10, which is within the 60th and 80th percentile,
reflecting above average recognition memory. This subtest tests the capacity for discrimination
between prior exposure and novel information. A good score indicates that the client has the
ability to correctly recognize familiar stimuli, reflecting an effective recognition system,
however, some areas may require improvement.
The client received a total raw score of 103, falling within the range of 80th to 100th
percentile, denoting excellent overall memory functioning. This elevated total score suggests
that the client has excellent cognitive functions in several areas of memory, such as long-term
recall, short-term retention, attention, concentration, and recognition. The memory performance
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is substantially above average, and it implies well-maintained neurological functioning and
effective information processing.
Summary
The client achieved a percentile of 60 to 80 on majority of the subtests which indicates that she
has an overall above average memory and the long term as well as short term memory of the
client is intact. Her total scores placed her in the excellent range from the 80th to 100th
percentile although she attained this only on a few subtests. She had a below average score in the
delayed recall subtest, various activities like association, visualization, etc can help improve this
area.
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References
Emmady, P. D., Schoo, C., & Tadi, P. (2022, November 19). Major Neurocognitive Disorder
(Dementia). StatPearls - NCBI Bookshelf.
https://www.ncbi.nlm.nih.gov/books/NBK557444/
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Abualhasan, A., Abu-Gharbieh, E., Akram, T. T., Hamad, H. A., Alahdab, F., Alanezi, F.
M., Alipour, V., Almustanyir, S., Amu, H., Ansari, I., Arabloo, J., Ashraf, T., . . . Vos, T.
(2022). Estimation of the global prevalence of dementia in 2019 and forecasted
prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. The Lancet
Public Health, 7(2), e105–e125. https://doi.org/10.1016/s2468-2667(21)00249-8
Pershad, D., & Wig, N. N. (). Manual for P.G.I. memory scale. National Psychological
Corporation. Retrieved January 31, 2025, from
https://www.scribd.com/document/781123303/Pgims-Manual
Pershad, D., & Wig, N. N. (n.d). Reliability And Validity Of A New Battery Of Memory Tests (P.
G. I. Memory Scale). Indian Journal of Psychiatry 20(1):p 76-80, Jan–Mar 1978. Tiwari,
M. (2021). PGI memory scale [PowerPoint slides]. SlideShare. Retrieved January 31,
2025, from https://www.slideshare.net/MissTiwari/pgi-memory-scalepsychology
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Appendix
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