title: Development of a cognitive screening instrument for tribal elderly population of Himalayan region in northern India.
abstract: BACKGROUND
  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.
  
  
  METHODS
  We used a systematic, item-by-item, process for development of a modified version of MMSE suitable for elderly tribal population.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Community Medicine, Dr. R.P. Government Medical College, Tanda, Himachal Pradesh, India.
authors.forename: Sunil Kumar
authors.initials: SK
authors.lastname: Raina
authors.forename: Sujeet
authors.initials: S
authors.lastname: Raina
authors.forename: Vishav
authors.initials: V
authors.lastname: Chander
authors.forename: Ashoo
authors.initials: A
authors.lastname: Grover
authors.forename: Sukhjit
authors.initials: S
authors.lastname: Singh
authors.forename: Ashok
authors.initials: A
authors.lastname: Bhardwaj
keywords: Cognitive; dementia; elderly; scale; tribal
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