Standardising Dementia Diagnosis Across Linguistic and Educational Diversity: Study Design of the Indian Council of Medical Research-Neurocognitive Tool Box (ICMR-NCTB)

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.

Social Cognition Deficits Are Pervasive across Both Classical and Overlap Frontotemporal Dementia Syndromes

“…The neuropsychological evaluation was done using Digit Span and the Trail-Making Test A & B (TMT A & B) for attention and executive functions [ 34 ], the Verbal Learning Test (VLT) and modified Taylor Complex Figure Test (MTCF) for episodic memory, the Picture Naming Test (PNT) for language assessment, and an MTCF copy was used for the assessment of visuospatial functions. These tests were derived from the Indian Council of Medical Research Neurocognitive Tool Box (the ICMR-NCTB), which is adapted and validated for use in Indian languages [ 35 ]. Semantic memory was assessed using a semantic association task, a subtask of the Indian version of the Cambridge Semantic Battery [ 36 ].…”

“…Social cognition was assessed in all patients using the IRI for empathy and POFA for emotion recognition [ 37 ]. These tests have been adapted and validated for the Indian context [ 34 , 35 , 36 ].…”

Propiedades Psicométricas del Addenbrooke's Cognitive Examination III: Estructura Factorial, Análisis TRI y Utilidad Diagnóstica para la detección de demencia en Atención Primaria de Salud

“…Dado el carácter clínico del diagnóstico, los profesionales necesitan contar con diversas fuentes de información para establecer adecuadamente la presencia del cuadro. Es por ello que los tests de screening neuropsicológico resultan fundamentales, dado que juegan un rol importante en la detección del deterioro cognitivo, en la caracterización clínica de éste y en la planificación de las intervenciones [6][7][8][9][10] .…”

Perceptual Priming Can Increase or Decrease With Aging

“…This is particularly important in the Indian context and perhaps even more so in clinical settings, where participants come from a wide variety of backgrounds (urban/rural and literate/illiterate), with heterogeneous levels of visual and verbal experience. These issues can be addressed by developing standardized measures for the Indian context (Iyer et al, 2020), and by tracking cognitive measures longitudinally.…”