Evaluating cognitive impairment among a geriatric population in India using the Indian Council of Medical Research (ICMR)-multilingual dementia research and assessment (MUDRA) toolbox

利用印度医学研究理事会 (ICMR) 多语言痴呆研究与评估 (MUDRA) 工具包评估印度老年人群的认知障碍

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Abstract

BACKGROUND: Cognitive impairment disproportionately affects the geriatric population in India due to a combination of nutritional, socioeconomic, and environmental factors. AIM: This study employed the culturally validated Indian Council of Medical Research (ICMR)-Multilingual Dementia Research and Assessment (MUDRA) Toolbox to investigate cognitive impairment among geriatric population in Gorakhpur, India and to assess their performance in the various cognitive domains of the MUDRA toolbox. METHODS: This cross-sectional study included 1013 participants aged over 60 years selected through multistage random sampling across seven blocks in Gorakhpur district. Participants who exhibited cognitive impairment on the Montreal Cognitive Assessment (MoCA) test underwent further assessments across multiple cognitive domains in the MUDRA Toolbox, including tests of attention and executive functions, episodic memory, language, and visuospatial functions. Data were analyzed using descriptive statistics, Chi-square test, Mann-Whitney U test, and multinomial logistic regression. RESULTS: Among 1013 participants, 847 screened positive on MoCA (70.4% mild, 13.2% moderate) for cognitive impairment and were assessed further for other domains of ICMR-MUDRA toolbox. Males performed significantly better than females across multiple MUDRA toolbox domains, including attention and executive functions, episodic memory, language, and visuospatial skills (P ≤ 0.05). Females showed higher error rates in Trail Making Tests and higher line bisection deviation (P < 0.001). CONCLUSION: Significant cognitive impairment exists among geriatric population in Gorakhpur. It could arise from the disparities in educational attainment and occupational engagement. These findings emphasize the need for early public health interventions specific for middle-aged population to delay the onset of cognitive impairment.

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