الفهرس 
AGING AND COGNITIVE FUNCTIONOnly 14 pages are availabe for public view
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Abstract
D
ementia is a condition that causes a gradual deterioration in cognitive functions,like memory, language, orientation, judgment, and physical abilities. The functional independence of seniors is heavily reliant on cognition, influencing their ability to live independently, manage finances, correctly handle medications, and drive safely.
About two thirds of patients with dementia reside in low and middle-income countries. Patients with lower socioeconomic status and less education are at higher risk for cognitive decline. Early detection, with a suitable screening test, may allow proper diagnosis, and management of cognitive impairment at a milder level.
The SLUMS enhances detection capabilities, and SLUMS is considered as a precise tool for diagnosing mild neurocognitive disorders and dementia, offering a better chance of identifying and treating these conditions effectively. The performance of illiterates and low educated elderly in cognitive tests including SLUMS was always a matter of debate, and in Arabic speaking countries as Egypt, more studies are needed.
The aim of this study was to assess the efficiency of the Arabic version of the Saint Louis University mental status (SLUMS) examination in a sample of illiterate and low-educated Egyptian in comparison to Clinical Dementia Rating (CDR) for detection of cognitive impairment.
We conducted a cross-sectional study that included ninety elderly participants, aged 60 years and above, who attended the Geriatric outpatients‘ clinic at Ahmed Shawki- Geriatric Medicine Hospital, Ain Shams University Hospitals, Cairo, Egypt. The elderly participants had either normal cognition or mild cognitive impairment, defined as CDR score 0-1. Our participants were classified to illiterates, 1-6 years of education, 6-9 years of education for further analysis. All participants had a comprehensive geriatrics assessment and cognitive assessment with Arabic version of the CDR and the Arabic version of the SLUMS.
The study showed that the Arabic version of slums had a high sensitivity of 95.4%, but with a low specificity at 38.3% for detection of mild cognitive impairment in illiterate and low educated Egyptian elderly. SLUMS is a valid yet not the best tool to screen for cognitive impairment and dementia in the illiterate and low educated Egyptian elderly.
CONCLUSION
Better cognitive performance is associated with higher functional status, healthy social integration, and activity (shown in married participants), and a higher level of education.
Lower cognitive function levels are significantly associated certain comorbidities including hypertension and malignancy.
There is fair to good agreement between the two assessment tools CDR and the SLUMS.
The SLUMS has high sensitivity but with low specificity in detecting MCI and mild dementia in illiterates and low educated elderly. Meaning that SLUMS is a valid yet not the best tool to screen for cognitive impairment and dementia in the illiterate and low educated Egyptian elderly.
RECOMMENDATIONS
Although SLUMS is a valid tool, but not the best tool to screen for cognitive impairment and dementia in the illiterate and low educated Egyptian elderly as it has high sensitivity but low specificity, so more research is needed on that field.
More funding towards development of a new assessment tools that meet the needs of low and middle-income countries.
Consider Cultural and Linguistic Diversity as proposed tools should be adaptable to the diverse cultures and languages in these countries and the development of originally Arabic assessment tools is paramount.
Adopt and utilize modern technology such as smart applications and wearable devices to develop advanced assessment tools that are cost-effective