Mini-Mental State Examination Performance Among Indian Army Veterans in Nepal: A Descriptive Cross-Sectional Study at ECHS Polyclinic Pokhara

Abstract

Introduction: Cognitive impairment and dementia are increasing public health concerns in low- and middle-income countries, yet little is known about cognitive status among Indian Army veterans residing in Nepal. This study described Mini-Mental State Examination performance among veterans attending an ECHS polyclinic using a locally translated Nepali-language version of the instrument; the adaptation was not treated as a population-validated diagnostic tool.

Methods: A descriptive cross-sectional study was conducted among 400 Indian Army ex-servicemen aged 50 years and above attending ECHS Polyclinic Pokhara for routine outpatient services between July and November 2025. The Nepali-language Mini-Mental State Examination retained the original domains and scoring. As formal educational data and diagnostic confirmation were not collected, results were interpreted descriptively using conventional cut-offs. Descriptive statistics, Pearson correlation, Spearman correlation, one-way analysis of variance and Tukey post-hoc testing were used.

Results: The mean Mini-Mental State Examination score was 29.14 ± 1.74; 392/400 (98.00%) veterans scored in the normal range. Age showed a moderate negative correlation with score (r = -0.46), with decline most evident after 80 years. Rank-related differences were statistically significant but clinically small.

Conclusion: Cognitive impairment was uncommon in this outpatient veteran cohort. The low prevalence should be interpreted cautiously because the sample was drawn from routine OPD attendees, formal educational data were unavailable, and the Nepali-language adaptation was not validated specifically in this veteran population. Opportunistic cognitive screening remains feasible in ECHS primary care settings and may help identify older veterans requiring further assessment.