Development and implementation of PHC-CST: A cognitive screening tool for early detection of dementia in primary health care settings in India (vol 21, e096673, 2025)

Background: The increasing prevalence of dementia in India highlights the need foreffective and accessible diagnostic tools in primary health care. Existing cognitivescreening tools face cultural and logistical challenges, reducing their applicability indiverse settings. The objective of the study was to develop, validate, and evaluate thePrimary Health Care Cognitive Screening Tool (PHC-CST) for the early detection ofdementia, tailored specifically for use in resource-limited settings in India.Methods: A single-stage study involving 97 participants aged 50 years and olderwas conducted at the Kaiwara Primary Health Care Centre in Karnataka, India. ThePHC-CST was designed through a multi-phase process, involving extensive inputfrom stakeholders, including nurses, doctors, and patients, to ensure cultural andcontextual relevance. Validation measures included sensitivity, specificity, and inter-rater reliability, benchmarked against the Montreal Cognitive Assessment (MoCA).The tool features simplified language, contextually relevant tasks, and a scoring systemadapted to local demographics.Results: The PHC-CST demonstrated strong validity, with a sensitivity of 89%and specificity of 85% for detecting early dementia. Stakeholders reported highease of use, minimal training requirements, and seamless integration into existingworkflows. Compared to MoCA, PHC-CST improved diagnostic accuracy and reducedadministration time. Qualitative feedback highlighted its cultural relevance andscalability in similar settings.Conclusion: The PHC-CST addresses critical gaps in dementia diagnosis within primaryhealth care settings in India. Its culturally tailored design, ease of use, and robustdiagnostic performance position it as a promising tool for early dementia detection,with the potential for broader application in low-resource environments