Assessing the cognitive status of older adults attending primary healthcare centers in Saudi Arabia using the Mini-Mental State Examination

Cognitive decline assessment in speakers of understudied languages

Projected trends in population aging have forecasted a massive increase in the number of people with dementia, in particular in sub-Saharan Africa and the Middle East and North Africa (MENA) region. Cognitive decline is a significant marker for dementia, typically assessed with standardized neuropsychological tools that have been validated in some well-researched languages such as English. However, with the existing language diversity, current tools cannot cater to speakers of understudied languages, putting these populations at a disadvantage when it comes to access to early and accurate diagnosis of dementia. Here, we shed light on the detrimental impact of this language gap in the context of the MENA region, highlighting inadequate tools and an unacceptable lack of expertise for a MENA population of a half billion people. Our perspective calls for more research to unravel the exact impact of the language gap on the quality of cognitive decline assessment in speakers of understudied languages.

Highlights

Cognitive decline is a marker for dementia, assessed with neuropsychological tests.There is a lack of culturally valid tests for speakers of understudied languages.For example, suboptimal cognitive tests are used in the Middle East and North Africa region.Linguistic diversity should be considered in the development of cognitive tests.

The Severity of Pain and Comorbidities Significantly Impact the Dependency on Activities of Daily Living among Musculoskeletal Patients in Jizan, Saudi Arabia

Limited research has been carried out on the effects of pain, comorbidity, and impaired function in musculoskeletal patients in Jizan, Saudi Arabia. A cross-sectional study was conducted on 115 patients (aged ≥ 55 years) with physician-diagnosed musculoskeletal conditions in Jizan to investigate the association between pain severity, comorbidities, and dependence on activities of daily living (ADLs). Self-reported questionnaires were used to collect data on pain, comorbidities, and physical function measured by ADLs. In ADLs, participants were categorized as dependent (n = 36) or independent (n = 79). Logistic regression analysis was employed to determine the predictors of dependence. The results showed that higher pain severity (adjusted odds ratio (OR): 1.69, 95% confidence interval (CI): 1.21-2.38, p = 0.002) and a greater number of comorbidities (adjusted OR: 1.52, 95% CI: 1.06-2.17, p = 0.021) were independently associated with dependence in ADLs. These associations remained significant even after controlling for covariates. This study concluded that patients with musculoskeletal conditions in Jizan who experience high levels of pain and comorbidities are at risk of dependence on basic daily activities. Therefore, addressing pain and comorbidities is crucial for maintaining independence and improving quality of life. Personalized rehabilitation programs are needed to manage these conditions in this region.

Morbidity profile among older people at primary health care centers in Saudi Arabia during the period 2012-2020

OBJECTIVES

To evaluate the morbidity profile and explore the geriatric giants, health problems, and their risk factors among old people in the older people health clinics at primary health care centers (PHCCs) in Saudi Arabia.

METHODS

This is a record-based descriptive cross-sectional study. Data was collected between 2012-2020 using the health data of older people to whom comprehensive geriatric assessment (CGA) was carried out at 1,481 PHCCs in Saudi Arabia. Data included sociodemographic and health related characteristics, medications, results of CGA, complete clinical examination, and laboratory results. Assessment was carried out for diabetes, hypertension, obesity, underweight, vision and hearing impairments, depression, memory and cognitive impairment, risk of falls, urine incontinence, bronchial asthma, and anemia.

RESULTS

A total of 193,715 older people were screened. A high prevalence of diabetes (55.4%), hypertension (49.1%), diabetes and hypertension co-morbidity (26.8%), and obesity (22.2%) were found. The overall prevalence of anemia was 4.7% and asthma 8.9%. The prevalence of positive screening for depression was 5.9%, 2.9% for memory and cognitive impairment, 6.3% for urine incontinence, and 4.0% for risk of fall. The prevalence of vision impairment was 20.6%, hearing impairments was 12.6%, and for underweight it was 5.4%. There was high prevalence of risk factors like smoking (8.5%), and polypharmacy (25.3%). Health regions varied widely in prevalence of the studied health conditions.

CONCLUSION

The study findings highlight the importance of CGA in early detection of geriatric giants, health problems, and associated risk factors among Saudi older people.

Prevalence of Dementia and Its Associated Risk Factors Among Geriatric Patients Visiting Primary Healthcare Centers in Riyadh, Saudi Arabia: A Cross-Sectional Study

Introduction: Dementia is a major cause of morbidity and dependence. The number of elderly individuals living with dementia worldwide is expected to rise up to 131 million by 2050. The Middle East and North Africa (MENA) is estimated to be one of the highest prevalence regions. However, there are limited numbers of studies in the region, especially on the primary care level. This study aims to determine the prevalence of dementia and identify the most important modifiable risk factors in our sample. 

Methods: A cross-sectional study design was used utilizing the non-probability convenience sampling technique. A questionnaire including demographic data, the Arabic version of the Patient Health Questionnaire (PHQ9) to screen for depression, and the Arabic version of the eight-item Alzheimer's Dementia (AD8) to screen for dementia, were administered to participants recruited from six primary healthcare centers in Riyadh city, Saudi Arabia. 

Results: This study found the prevalence of dementia to be 16% and 11% assuming cutoff points of 3 and 4, respectively, using the Arabic version of AD8, with depression and dyslipidemia as important modifiable risk factors for dementia in our sample. 

Conclusion: Primary healthcare professionals should be aware of the important modifiable risk factors such as dyslipidemia and depression in the population to be able to develop strategies for early detection and slowing down the progression of dementia. Further research to identify other modifiable risk factors in the population is recommended.