Cognitive Impairment among Hindi Mental State Examination Positive Community-Dwelling Rural Older Adults

Background: Cognitive impairment is emerging as one of the greatest mental health challenges in older adults. Its proper screening is required primarily. This article aimed to determine the usefulness of cognitive screening and assessment tools for ascertaining cognitive impairments among community-dwelling rural older adults. Methods: Lucknow rural elderly project was funded by the Indian Council of Medical Research, carried out in randomly selected rural areas of Lucknow district. The present article is based on the archived data of the same project. We have analyzed 1243 patients' data, who participated in the referred study. Data related to sociodemographic details, Hindi Mental State Examination (HMSE), were extracted. There were 81 patients who screened as HMSE positives (scored ≤23). These patients were then assessed using the Cambridge Examination for Mental Disorders of the Elderly-Revised to reach to a diagnostic category as per the International Classification of Diseases-10th Revision DCR criteria. Further, a triad of Brief Cognitive Rating Scale (BCRS), Functional Assessment Staging (FAST), and Global Deterioration Scale (GDS) administered on the cognitively impaired patients. The data were analyzed by employing SPSS version 15. Results: Among HMSE positives, 81.5% (66) had a diagnosable cognitive impairment and 18.5% (15) non-cases. FAST, BCRS, and GDS had concordant findings and were found to be effective instruments for the assessment of severity of cognitive decline. Conclusion: HMSE is a useful cognitive screening tool for rural older adults. A triad of BCRS, and GDS is found to be useful in determining the severity of cognitive impairment.