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A Hindi version of the MMSE: the development of a cognitive screening instrument for a largely illiterate rural elderly population in India
The Indo-US Cross-National Dementia Epidemiology Study seeks to compare two rural populations, in the US and India: the Monongahela Valley, a rural community of relatively low socioeconomic status in southwestern Pennsylvania (USA), and Ballabgarh, a rural community near New Delhi in North India. Of particular interest is the fact that the Ballagbarh elderly population is exlusively Hindi-speaking, hjas little or no education and is largely illiterate, rendering its cognitive screening a particular challenge. In this article we report methods and preliminary data on the development of a Hindi congitive screening instrument suitable for the Ballabgargh elderly population. We use as an example our Hindi adaptation of the Mini-Mental State Examination (MMSE), a widely used global cognitive screening scale. Systematic, item-by-item, emprically based test development has shown 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. Certain cognitive functions, particularly orientation to time, remain difficult to test adequately in this type of population. In Ballabgarh, as in the Monongahela Valley, educated individuals obtain higher test scores. implications for dementia screening are discussed, including those relevant to the hypothesis that low education predisposes to dementia
ISSN : 0885-6230
International journal of geriatric psychiatry A. 1995, vol. 10, n° 5, pp. 367-377 [bibl. : 22 ref.]
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