Burden of Mild Cognitive Impairment among the Elderly in India: A Systematic Review and Meta-Analysis

Mild cognitive impairment (MCI) represents a transitional state between normal cognitive aging and dementia, with significant implications for public health. The objective of our study was to estimate the pooled prevalence of MCI among Indian elderly individuals (≥60 years). We conducted a systematic review and meta-analysis in accordance with PRISMA-2020 guidelines. Four databases (PubMed, Scopus, Embase, Web of Science) were searched up to January 2025. Twenty-six studies met the eligibility criteria. Random-effects models were used to calculate pooled prevalence with 95% confidence intervals (CIs), stratified by community- and hospital-based settings. Heterogeneity was assessed using I² and τ² statistics. Subgroup and meta-regression analyses examined potential sources of heterogeneity. Publication bias was evaluated using funnel plots, Egger's regression test. The methodological quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. The pooled prevalence of MCI was 21% (95% CI: 13%-29%) in community settings and 44% (95% CI: 31%-57%) in hospital-based populations. Higher prevalence was observed among individuals with type 2 diabetes (53%), hypertension (57%), and those undergoing hemodialysis (38%). Diagnostic tool choice significantly influenced prevalence, with MoCA-based assessments yielding higher estimates than MMSE or Petersen criteria. Substantial heterogeneity was present across studies (I² >96%). Publication bias was minimal. MCI is prevalent among India's elderly population, particularly in individuals with chronic conditions. These findings underscore the need to integrate cognitive screening into national noncommunicable disease programs and to adopt standardized, context-appropriate diagnostic protocols for early identification and intervention.