Original article / research
Development of a Screening Tool for Analysing the Risk of Acquiring Cognitive Decline in Middle-aged Adults using the Modified Delphi Technique
YC17-YC21
Correspondence
Dr. Agrima Aggarwal,
PhD Scholar, Mahatma Gandhi University of Medical Sciences and Technology, RIICO Institutional Area Sitapura, Tonk Road, Jaipur-302022, Rajasthan, India.
E-mail: agrima.aggarwal@gmail.com
Introduction: In India, cognitive decline is increasingly recognised as a midlife concern; one in ten individuals exhibits signs of cognitive decline after age 45 years. Demographic variations, lifestyle behaviours, and physical and mental capacities influence heterogeneous trajectories of cognitive function. Declines in cognition adversely affect task performance and daily functioning, undermining occupational capacity and overall health and wellbeing. Early identification of at-risk middle-aged adults may enable targeted prevention and health promotion interventions.
Aim: To achieve expert consensus on a novel screening tool for identifying the risk of cognitive decline in middle-aged adults using the modified Delphi technique.
Materials and Methods: A consensus study using the modified Delphi technique was conducted from July 2024 to March 2025 at Mahatma Gandhi Occupational Therapy College, Jaipur, Rajasthan, India. Three rounds of the modified Delphi method were utilised. A panel of multidisciplinary experts was selected, comprising individuals with at least a Master’s degree in their respective disciplines and at least 10 years of experience in the field. In Rounds 1 and 2, experts rated item relevance on a 5-point Likert scale; Round 3 focused on establishing the Content Validity Index (CVI). Statistical analysis was conducted using the median and Interquartile Range (IQR), along with item- and scale-level CVI, to compute universal agreement.
Results: An initial pool of 30 items was designed, from which the panel reached consensus on 18 (60%) and 20 (83.3%) items in the first two rounds, respectively. Three items were removed after achieving >75% consensus for disagreement, with a wider IQR and higher variability. Using an I CVI threshold of ≥0.79 in the final round, 20 items met content validity criteria and were retained in the final instrument. The CVR and CVI values on the scale were 0.78 and 0.89, demonstrating good content validity of the tool, with a 65.2% rate of universal agreement.
Conclusion: The 20-item screening tool was developed through structured expert consensus and demonstrates strong content validity. This tool could facilitate the identification of middle-aged adults at risk of cognitive decline and inform preventive and health promotion strategies.