Context: With the aging of Indian society, maintaining salubrious cognitive health in late life is a public health priority. Early detection and possible prevention of cognitive impairment (CI), thus, will help in increasing the quality of life of elderly people and decreasing the social, psychological, and economic burden of their families and caregivers. Aims: The study aimed to assess proportion of CI and its predictors. Settings and Design: This community-based cross-sectional study was conducted among 135 elderly people selected from 15 villages out of a total 64 villages in rural field practice area Singur of AIIH&PH, Kolkata. Methods and Material: Cluster sampling technique was used and villages were selected according to probability proportional to size method. Data was collected using a predesigned, pretested structured schedule, which included sociodemographic and behavioral variables, Montreal cognitive assessment tool, Geriatric depression scale short form (GDS 15), and mini nutritional assessment tool. Statistical Analysis Used: Predictors of CI were assessed by univariate and multivariable logistic regression using MS-Excel 2016 and SPSS version 16 software. Results: Mean age of the study participants was 67.03 ± 6.7 years with 51.9% of them being females. Proportion of CI was observed to be 48.1% which was significantly associated with increasing age [AOR = 1.1 (1.02–1.13)], decreasing years of schooling [AOR = 1.1 (1.01–1.2)], depression [AOR = 2.7 (1.3–5.8)], and malnourished group [AOR = 4.5 (1.01–20.3)] Conclusion: The burden of CI among the study population was found to be quite high. It is an alarming situation which needs improved screening facility for early detection. Nutritional upliftment and screening for depression should also be done on a regular basis.

Introduction: Alzheimer Questionnaire (AQ) and Montreal Cognitive Assessment (MoCA) are tools for assessment of cognitive impairment. MoCA is a common tool for screening of cognitive impairment but it requires trained personnel. AQ questionnaire is informant-based, simple and less time consuming with or without the involvement of trained personnel. Aim: To estimate the prevalence of cognitive impairment and to find out the accuracy of AQ compared to MoCA in Cognitive Impairment screening among elderly population in an urban area of West Bengal. Materials and Methods: The Prospective cross-sectional study was conducted in urban field practice area of All India Institute of Hygiene and Public Health, Kolkata among 140 randomly selected elderly population from June to September 2019. Accuracy of AQ with MoCA tool as gold standard in screening cognitive impairment was analysed by Cohen’s Kappa, Receiver Operating Characteristics (ROC) Curve, Spearman rho Coefficient along with sensitivity, specificity, predictive values and likelihood ratio was obtained. Results: Prevalence of cognitive impairment using MoCA and AQ was 40% (95% CI=31.8-48.6) and 36.4% (95% CI=28.5-45.0), respectively. AQ and MoCA showed good agreement (Cohen’s kappa, κ=0.834; 95% CI=0.739-0.928). The AQ and MoCA showed a strong negative correlation (spearman’s Rho=-0.709; 95%CI=0.764-0.884, p-value <0.001). Considering MoCA as gold standard, AQ showed sensitivity of 85.7% (95% CI=74.2-92.6), specificity of 96.4% (95% CI=89.9-98.7) for cognitive impairment screening and the Positive predictive value of this tool was 94.1% (95% CI=84.0-97.9%). The Youden index of 0.821 showed highest sum of sensitivity and specificity of AQ tool at 4.5 score to anticipate cognitive impairment. Conclusion: AQ is equally effective as MoCA to screen cognitive impairment among elderly at the community level. AQ can be used even by grass root level health workers without involvement of trained personnel. So, community level screening of elderly for cognitive dysfunction can be made even in resource poor settings. Early identification and referral of elderly with cognitive dysfunction will help them in better living.

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Introduction: Diabetes is one of the major disease burdens in the world. Globally around 463 million people (at a prevalence of 9.3%) suffered from diabetes recently. Apart from morbidity and mortality, diabetes poses high economic burden on healthcare systems, especially on national economies in developing countries like India. Estimation of the cost burden of diabetes can help decision-makers to understand the magnitude of the problem, prioritize research efforts and interventions, and plan resource allocation, especially in resource-poor settings. The focus of our review was to summarize cost burden of diabetes and its determinants from existing literature in the last 10 years in India. Materials and Methods: All literatures published in the period 2010–2020 were accessed through two databases: PubMed and Google Scholar. Reference lists of the article were again searched for further literatures. Cost calculated in different times was converted to current price in 2020 for ease of comparison. Results: Studies reported a wide range of expenditures in different settings of care. Inequity of expenses across income quintiles among patients was found. Complication of diabetes, insulin therapy, treatment in private facility, and events of hospitalization were the factors associated to high expenditure burden. Conclusion: Financial risk protection for vulnerable people and control over medicine market price will reduce out-of-pocket expenditure for diabetes. Comprehensive strategy to delay onset of complication as well as its early detection can be an opportunity to cut down diabetes-related economic burden.