Indo-US Cross-National Dementia Epidemiology Study



Scientific Reports


Norms on Cognitive Screening Tests


Key Personnel

Student Activities


For a brief slide show reviewing the study background and design, click HERE.

Participating Institutions

(1) University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology & School of Medicine, Department of Psychiatry, Pittsburgh, Pennsylvania, USA

(2) Centre for Ageing Research, India, with the cooperation of the Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India

     Study Sites:  Ballabgarh, Haryana (India) & Monongahela Valley, Pennsylvania (USA)

                                                                                                Map courtesy of used with permission

Supported by Research Grant #AG09202 from the National Institute on Aging, National Institutes of Health, U.S. Department of Health and Human Services.

This collaborative project was funded under an NIA ongoing program of “cross-national investigations into the epidemiology of Alzheimer’s disease and other dementias of later life” (NIH Guide to Grants and Contracts 1988, 17:25). The rationale of the NIA program was that comparisons of dementia epidemiology between the US and other countries would reveal similarities and differences which would help identify new risk factors for dementia.

The overall objectives of the Indo-US Cross-National Dementia Epidemiology Study were: a) to determine the prevalence and incidence of, and risk factors for, Alzheimer's and other dementias in a defined Indian community (Ballabgarh), and b) to compare these results with those found in a reference U.S. community (Monongahela Valley). 

To achieve these objectives, we first developed suitable cognitive and activities assessment screening instruments for use in India, which would 1) be culturally fair, psychometrically sound, and valid for a population with little or no education; 2) be optimally sensitive and specific for dementia; and 3) allow not only the identification but also the more detailed characterization of dementia, and of normal and abnormal cognitive aging. 

Of note, the elderly members of the Ballabgarh population were exclusively Hindi-speaking, have very little or no education; the majority are illiterate.    Further, the study in the reference US population had already been in progress for some years. Thus, methods for the study of the Indian population had to be based on appropriate modification and adaptation of those already in place in our US study. The first 3 years of the project were devoted to instrument development. We have published two articles on cross-national research involving illiterate study populations in developing countries, one on general principles and one on practical aspects of cognitive testing.

We acknowledge support from the Neuroscience and Neuropsychology of Aging (NNA) Program, National Institute on Aging (NIA); in particular, the encouragement received from Teresa S. Radebaugh, ScD, former Chief, Dementia of Aging Branch, and other program staff during the course of this project.