Gowri K Iyer1,2, Avanthi Paplikar3, Suvarna Alladi1,3, Aparna Dutt4,5, Meenakshi Sharma6, Shailaja Mekala1,7, Subhash Kaul1,8, Aralikatte Onkarappa Saroja9, Gollahalli Divyaraj1, Ratnavalli Ellajosyula10, Amitabha Ghosh4, Roopa Hooda11, Sunita Justus12, Rajmohan Kandukuri1, Arfa Banu Khan9, Robert Mathew13, P S Mathuranath3,12, Ramsekhar Menon12, Ranita Nandi4, Jwala Narayanan10, Ashima Nehra11, M V Padma11, Apoorva Pauranik14, Subasree Ramakrishnan3, Prerana Sabnis10,15, Lekha Sarath12, Urvashi Shah16, Manjari Tripathi11, P N Sylaja12, Ravi Prasad Varma12, Mansi Verma11, Feba Varghese3. 1. Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad 500082, India. 2. Indian Institute of Public Health, Hyderabad 500033, India. 3. Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India. 4. Apollo Gleneagles Hospital, Cognitive Neurology Unit, Kolkata 700097, India. 5. Duttanagar Mental Health Centre, Neuropsychology & Clinical Psychology Unit, Duttanagar, Kolkata 700077, India. 6. Indian Council of Medical Research, New Delhi 110029, India. 7. Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich 80336, Germany. 8. Department of Neurology, Krishna Institute of Medical Sciences, Hyderabad 500082, India. 9. Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belgaum 590010, India. 10. Department of Neurology, Manipal Hospitals, Bengaluru 560071, India. 11. Neurosciences Center, All India Institute of Medical Sciences, Delhi 110023, India. 12. Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram 695011, India. 13. Department of Neurology, Government Medical College, Alleppey 688005, India. 14. Department of Neurology, G.M. Medical College, Indore 452001, India. 15. Center for Mind/Brain Sciences, University of Trento, Center for Mind/Brain Sciences, Rovereto 38068, Italy. 16. Department of Neurology, King Edward Memorial Hospital, Mumbai 400012, India.
Abstract
OBJECTIVES: While the burden of dementia is increasing in low- and middle-income countries, there is a low rate of diagnosis and paucity of research in these regions. A major challenge to study dementia is the limited availability of standardised diagnostic tools for use in populations with linguistic and educational diversity. The objectives of the study were to develop a standardised and comprehensive neurocognitive test battery to diagnose dementia and mild cognitive impairment (MCI) due to varied etiologies, across different languages and educational levels in India, to facilitate research efforts in diverse settings. METHODS: A multidisciplinary expert group formed by Indian Council of Medical Research (ICMR) collaborated towards adapting and validating a neurocognitive test battery, that is, the ICMR Neurocognitive Tool Box (ICMR-NCTB) in five Indian languages (Hindi, Bengali, Telugu, Kannada, and Malayalam), for illiterates and literates, to standardise diagnosis of dementia and MCI in India. RESULTS: Following a review of existing international and national efforts at standardising dementia diagnosis, the ICMR-NCTB was developed and adapted to the Indian setting of sociolinguistic diversity. The battery consisted of tests of cognition, behaviour, and functional activities. A uniform protocol for diagnosis of normal cognition, MCI, and dementia due to neurodegenerative diseases and stroke was followed in six centres. A systematic plan for validating the ICMR-NCTB and establishing cut-off values in a diverse multicentric cohort was developed. CONCLUSIONS: A key outcome was the development of a comprehensive diagnostic tool for diagnosis of dementia and MCI due to varied etiologies, in the diverse socio-demographic setting of India.
OBJECTIVES: While the burden of dementia is increasing in low- and middle-income countries, there is a low rate of diagnosis and paucity of research in these regions. A major challenge to study dementia is the limited availability of standardised diagnostic tools for use in populations with linguistic and educational diversity. The objectives of the study were to develop a standardised and comprehensive neurocognitive test battery to diagnose dementia and mild cognitive impairment (MCI) due to varied etiologies, across different languages and educational levels in India, to facilitate research efforts in diverse settings. METHODS: A multidisciplinary expert group formed by Indian Council of Medical Research (ICMR) collaborated towards adapting and validating a neurocognitive test battery, that is, the ICMR Neurocognitive Tool Box (ICMR-NCTB) in five Indian languages (Hindi, Bengali, Telugu, Kannada, and Malayalam), for illiterates and literates, to standardise diagnosis of dementia and MCI in India. RESULTS: Following a review of existing international and national efforts at standardising dementia diagnosis, the ICMR-NCTB was developed and adapted to the Indian setting of sociolinguistic diversity. The battery consisted of tests of cognition, behaviour, and functional activities. A uniform protocol for diagnosis of normal cognition, MCI, and dementia due to neurodegenerative diseases and stroke was followed in six centres. A systematic plan for validating the ICMR-NCTB and establishing cut-off values in a diverse multicentric cohort was developed. CONCLUSIONS: A key outcome was the development of a comprehensive diagnostic tool for diagnosis of dementia and MCI due to varied etiologies, in the diverse socio-demographic setting of India.
Entities:
Keywords:
Cognition; Cross cultural validation; India; Neuropsychological assessment; Standardisation; Stroke