الفهرس 
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Abstract
The aging population has led to a higher prevalence of chronic diseases and dysfunctions among older adults. That is challenging the social security and health care systems.
CI, as a chronic non-communicable disease, is becoming an important public health concern. That refers broadly to various degrees of CI from various causes, ranging from mild cognitive impairment (MCI) to dementia.
Because of the greater socioeconomic distributional disparities in developing countries like Egypt, it is important to understand what factors contribute to the differing levels of cognitive health among people from lower and higher socioeconomic groups.
So the aim of this study was to examine the pattern of cognitive impairment among community dwelling elderly and its relation to socioeconomic status.
It was across sectional study included 470 elderly males and females recruited from community dwelling elderly living in Kafr El Sheikh government, Egypt.
Mean age of the study population was 66.32 years old with standard deviation ±5.61. Most of the study population were males, married, have low education with no special habits of medical importance.
According to MoCA test results our findings indicate a considerable burden of CI in this population, with an estimate of 50.2 % of participants distributed as 37.66% had MCI and 12.55% were demented.
CI was significantly associated with increasing age, female sex, marital status single or widow, low education and with increasing total number of comorbidities and most of medical disorders e.g. DM, hypertension, CVD, neurological diseases, sensory impairment and depression. Also CI was associated with positive FH of CI.
According to Hachinski test examination of cognitively impaired subjects the most common type of cognitive impairment was degenerative type (47.8%) followed by mixed type (37.7%) and then vascular type (14.4%).
For assessment of specific cognitive domain affection, we used a newly developed valid battery named Ain Shams Cognitive Assessment battery (ASCA) scale.
The most affected ASCA subtest was BG recall while Abstraction had the least affected one. With comparison between both educational groups there was significant difference in the performance among most of the ASCA subtests with significant p value.
The most affected cognitive sub domain was related to memory functions including (working spatial followed by language and semantic then working encoding memory) and the least affected sub domain was abstraction.
Being impaired on at least one domain was common across all five domains of learning and memory, attention, executive function, language and perceptual motor functions.
The estimated prevalence of domain-specific impairment ranged from 94% for perceptual-motor function to 12.7% for abstraction, with the other domains being 88% for language and semantic memory, 75% for attention, 69% for executive functions, 30% for learning and verbal memory and 25% for judgment. Co-occurrence of impairment across domains was very common.
With comparison of the cognitive performance across domains and the educational level it was found that working memory function was the most affected domain among the highly educated group followed by visuospatial and executive functions, while among illiterate and low educated group the visuospatial function was the most affected domain followed by language and semantic memory functions with significant difference between the two groups as regard all domain functions except for attention, abstraction and judgment.
Diversity in cognitive performance and different rates of cognitive decline have been reported to be altered with regard to demographic characteristics, education, lifestyle, physical conditions, social engagement, and economic resources.
In the current study it was found that CI (MCI and dementia) was highly associated with SES level. That demented subjects had a higher distribution of low SES level than both normal and MCI subjects while normal subjects a higher distribution of high and medium SES level than both MCI and demented subjects.
Also, there was a statistical significance between SES level and performance across ASCA subtests that the worst performance was among low SES group, moderate performance was among medium SES group and highest performance was among high SES group. With most of significant difference was between the low and both medium and high groups of subjects.
And also there was a statistical significance between cognitive function (normal, MCI, demented) and all SE domains including educational level, occupation, computer use, income and sanitation. That CI was associated with low educational level, non-occupied, limited computer use, low income and bad sanitation.
Findings suggest that older adults with lower perceived income, lower levels of education, poor physical and mental health, and poor physical and social resources were more likely to be cognitively impaired. Hence, these factors can be adopted further to evaluate the health inequalities and develop better policies and programs for target areas in future policy formulation to reduce the inequality in CI in older adults.