Paper short abstract:

Using the concept of ‘fluidity’ from Science and Technology Studies, this paper analyses the cultural and contextual fluidity of the Mini Mental State Examination (MMSE) in screening for dementia in urban India.

Paper long abstract:

The Mini Mental State Examination (MMSE) is a popular screening instrument for dementia. Drawing on ethnographic data from India, three vignettes are presented to examine how the MMSE is operationalised by interviewers and respondents. Using the concept of 'fluidity' from Science and Technology Studies, it will be demonstrated that the MMSE is fluid and changes according to individual norms, institutional resources, and cultural settings. In some environments, the scores are discounted in order to count; in others, the scale is perceived as an invitation to talk; and finally, the MMSE can also operate as an entry-point to seek treatment for other psychological concerns. It will be argued that while within a GMH agenda, the so-called rigour and reliability of the MMSE is compromised, as a fluid object, the scale can become a contextually and culturally relevant tool that allows for extra-screening 'talk.' It is this talk that gives health professionals clues about cognition and impairment thus allowing them to make more evidence-informed decisions about treatment and management pathways.