This project represents a collaboration across the Health and Retirement Study (HRS) international partner studies with the aim of developing a harmonized diagnostic assessment protocol for dementia and cognitive impairment without dementia (CIND), to be used in the ongoing, nationally representative Longitudinal Aging Survey in India (LASI). We propose to develop this diagnostic assessment protocol by first linking doctor diagnosis in a sample of patients at four geriatric hospitals in India to two dementia test protocols ? the HRS Harmonized Cognitive Assessment Protocol (HCAP) and the 10/66 Community Screening Interview for Dementia (CSI-D) ? and cognition tests from the LASI core survey. We will then examine the data generated at this first stage to develop an adaptive test protocol to be used for the in-home assessment of dementia and CIND, contingent on subjects? performance on the LASI core cognitive tests. The proposed supplemental study to the ongoing representative, longitudinal LASI study will enable the investigation of dementia and CIND in a nationally representative sample of older Indians. The two-stage development of an adaptive test protocol will ensure both the clinical accuracy of diagnosis and community-level representation, not bound by accessibility to health care. Integrating the new data with the rich data from the main LASI study will enable the estimation of economic and care giving burden associated with cognitive decline among older adults in India.