07.01.04. Are there differences in diagnostic assessment according to geographical areas (rural/urban) and also according to other socio-economic factors? | India

07.01.04. Are there differences in diagnostic assessment according to geographical areas (rural/urban) and also according to other socio-economic factors? | India

08 Jul 2022

There are differences in diagnostic assessment across the country due to diversity in demographics (rural/urban, region and state) and socioeconomic status. Diagnostic tools have been developed and/or adapted to account for this diversity. The Indian Council of Medical Research (ICMR), Department of Health Research (2021), released a Neurocognitive Tool Box. It is culturally validated and available in 5 Indian languages (Hindi, Bengali, Telugu, Kannada and Malayalam) (ICMR, 2021). The 10/66 Dementia Research Group has developed a cross-culturally validated dementia diagnostic algorithm (Prince et al., 2008). There are also other neuropsychological assessments that have been translated into various regional languages as well as culturally adapted to the Indian context. These include: Addenbrookes Cognitive Examination (ACE) (Version III and Version R), Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessments (MoCA) (Porrselvi and Shankar, 2017).

Table 7.1 shows the Cognitive screening measures with Indian adaptions:

Global Screening Measures Indian adaptation Literacy / socioeconomic background
Mini Mental State Examination Hindi mental state examination (HMSE) Hindi-speaking, illiterate, rural elderly population.
Addenbrooke’s Cognitive Examination-Revised and ACE III Tamil, Hindi, Indian English, Kannada, Telugu, Urdu, Malayalam and Marathi. Literate and illiterate versions.
Montreal Cognitive Assessment (MoCA) Bengali, Kannada, Malayalam, Marathi, Tamil, Telugu, Hindi, and Urdu. Computerized version in development.
Community Screening Instrument for Dementia   Developed for use in primary care settings by non-specialist health workers.
Kolkata Cognitive Screening Battery Bengali Test developed for Kolkata population.
Mattis Dementia Rating Scale Hindi Hindi-speaking Indian population.
Rowland Universal Dementia Assessment tool (RUDAS) Malayalam Kerala state population
Picture-based memory impairment screen Used for all languages Culture-fair (measure cognition without the influence of sociocultural factors), picture-based cognitive screen designed to be administered by non-specialists.

Source: (Porrselvi and Shankar, 2017)


Indian Council of Medical Research (ICMR). 2021. INDIAN COUNCIL OF MEDICAL RESEARCH -NEURO COGNITIVE TOOLBOX (ICMR-NCTB). Available from: http://brandp.in/icmr/index.html

Porrselvi, A.P., Shankar, V., 2017. Status of Cognitive Testing of Adults in India. Ann. Indian Acad. Neurol. 20, 334–340. https://doi.org/10.4103/aian.AIAN_107_17

Prince, M. J., De Rodriguez, J. L., Noriega, L., Lopez, A., Acosta, D., Albanese, E., … & Uwakwa, R. (2008). The 10/66 Dementia Research Group’s fully operationalised DSM-IV dementia computerized diagnostic algorithm, compared with the 10/66 dementia algorithm and a clinician diagnosis: a population validation study. BMC public health, 8(1), 1-12. https://doi.org/10.1186/1471-2458-8-219