There are various approaches for adding indexes, but here's a typical way to add index entries.

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In the prolog | metadata | keywords element of a topic, add index terms The prolog element comes just after the shortdesc element (which follows the title). Here's a sample:
<title>My Title</title>
 <shortdesc/>
<prolog>
    <metadata>
      <keywords>
        <indexterm>cars</indexterm>
      </keywords>
    </metadata>
  </prolog>
You can also nest index entries inside of each other to create parent-child relationships among the index terms:
  <prolog>
    <metadata>
      <keywords>
        <indexterm>cars
                <indexterm>sedan</indexterm>
        </indexterm>
      </keywords>
    </metadata>
  </prolog>
The result in the index will look like this:
cars
  - sedan

When you want to create a "see" entry for an index, code it like this:

   <indexterm>vehicle
   <index-see>car</index-see>
</indexentry>
  

The result of the index-see element is the following:

    vehicle, see car
   

If you want to include a page number with the see also reference, write it like this:

    <indexterm>vehicle
   <index-see-also>car</index-see-also>
</indexentry>
    </indexterm>
  

The output will look like this:

    vehicle ..... 23
           see also car
   

Keep in mind that index entries added to the prolog section will include page numbers pointing to the location of the prolog. Since most topics are short, this isn't a problem. Also, since the online help is usually the main deliverable, it's also not a problem. However, you can also add index entries in the middle of your topics. (But apparently this causes some problems, especially with translation.)

Also, some PDF renderers don't include page numbers to index entries. At any rate, since PDF isn't usually the main deliverable, this is not a concern with index terms.