Background/Aims: In a linguistically diverse country such as India, challenges remain with regard to diagnosis of early cognitive decline among the elderly, with no prior attempts made to simultaneously validate a comprehensive battery of tests across domains in multiple languages. This study aimed to determine the utility of the Indian Council of Medical Research-Neurocognitive Tool Box (ICMR-NCTB) in the diagnosis of mild cognitive impairment (MCI) and its vascular subtype (VaMCI) in 5 Indian languages. Methods: Literate subjects from 5 centers across the country were recruited using a uniform process, and all subjects were classified based on clinical evaluations and a gold standard test protocol into normal cognition, MCI, and VaMCI. Following adaptation and harmonization of the ICMR-NCTB across 5 different Indian languages into a composite Z score, its test performance against standards, including sensitivity and specificity of the instrument as well as of its subcomponents in diagnosis of MCI, was evaluated in age and education unmatched and matched groups. Results: Variability in sensitivity-specificity estimates was noted between languages when a total of 991 controls and 205 patients with MCI (157 MCI and 48 VaMCI) were compared due to a significant impact of age, education, and language. Data from a total of 506 controls, 144 patients with MCI, and 46 patients with VaMCI who were age- and education-matched were compared. Post hoc analysis after correction for multiple comparisons revealed better performance in controls relative to all-cause MCI. An optimum composite Z-score of −0.541 achieved a sensitivity of 81.1% and a specificity of 88.8% for diagnosis of all-cause MCI, with a high specificity for diagnosis of VaMCI. Using combinations of multiple-domain 2 test subcomponents retained a sensitivity and specificity of #x3e;80% for diagnosis of MCI. Conclusions: The ICMR-NCTB is a “first of its kind” approach at harmonizing neuropsychological tests across 5 Indian languages for the diagnosis of MCI due to vascular and other etiologies. Utilizing multiple-domain subcomponents also retains the validity of this instrument, making it a valuable tool in MCI research in multilingual settings.
Dement Geriatr Cogn Disord

中文翻译：

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印度医学研究委员会神经认知工具箱在印度轻度认知障碍诊断中的验证：来自语言多样社会的和谐进程的经验教训

背景/目标：在语言多样的国家（例如印度）中，老年人的早期认知能力下降的诊断仍然面临挑战，而此前尚未尝试同时验证多种语言跨领域的综合测试。这项研究旨在确定印度医学研究理事会-神经认知工具箱（ICMR-NCTB）在以5种印度语言诊断轻度认知障碍（MCI）及其血管亚型（VaMCI）中的实用性。方法：使用统一的流程招募了来自全国5个中心的文盲受试者，并根据临床评估和金标准测试方案将所有受试者分为正常认知，MCI和VaMCI。在将ICMR-NCTB在5种不同的印度语言中适应和协调成一个综合Z分数后，根据年龄和教育程度评估了其针对标准的测试性能，包括该仪器的敏感性和特异性以及其在诊断MCI中的子组件。不匹配和匹配的组。结果：当比较了991名对照和205名MCI患者（157 MCI和48 VaMCI）时，由于年龄，教育程度和语言的重大影响，各语言之间的敏感性-特异性估计值存在差异。比较了总共506名对照，144名MCI患者和46名VaMCI患者的年龄和文化程度匹配的数据。校正后进行多次比较后的事后分析显示，与所有原因的MCI相比，对照组的表现更好。最佳复合Z评分为-0.541，对于全因MCI的诊断灵敏度为81.1％，特异性为88.8％，对VaMCI的诊断特异性很高。使用多域2测试子组件的组合可保留＃x3e的敏感性和特异性；诊断MCI的80％。结论：ICMR-NCTB是一种“同类首创”的方法，用于协调5种印度语言的神经心理学测试，以诊断由于血管和其他病因引起的MCI。利用多域子组件也保留了该工具的有效性，使其成为多语言环境下MCI研究的重要工具。
Dement Geriatr Cogn Disord