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J Neurosci Rural Pract. 2013 Apr;4(2):147-53. doi: 10.4103/0976-3147.112744.

Development of a cognitive screening instrument for tribal elderly population of Himalayan region in northern India.

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Department of Community Medicine, Dr. R.P. Government Medical College, Tanda, Himachal Pradesh, India.



Cognitive impairment, characteristic of dementia, is measured objectively by standard neuropsychological (cognitive) tests. Given the diversity of culture and language in India, it is difficult to use a single modified version of MMSE uniformly to Indian population. In this article, we report methods on the development of a cognitive screening instrument suitable for the tribal (Bharmour) elderly (60 years and above) population of Himachal Pradesh, India.


We used a systematic, item-by-item, process for development of a modified version of MMSE suitable for elderly tribal population.


The modifications made in the English version of MMSE and the pretesting and pilot testing thereof resulted in the development of Bharmouri version of cognitive scale.


The study shows that effective modifications can be made to existing tests that require reading and writing; and that culturally sensitive modifications can be made to render the test meaningful and relevant, while still tapping the appropriate cognitive domains.


Cognitive; dementia; elderly; scale; tribal

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