Validation of the Mini-Addenbrooke's Cognitive Examination in Mild Cognitive Impairment in Arabic Speakers.

INTRODUCTION: Mild cognitive impairment (MCI) represents a target for early detection and intervention in dementia, yet there is a shortage of validated screening tools in Arabic to diagnose MCI. The mini-Addenbrooke's Cognitive Examination (m-ACE) is a brief cognitive battery that is scored out of 30 and can be administered in under 5 min providing a quick screening tool for assessment of cognition. OBJECTIVE: We aimed to validate the m-ACE in Arabic speakers in Egypt with MCI to provide cut-off scores. METHODS: We included 24 patients with MCI and 52 controls and administered the Arabic version of the m-ACE. RESULTS: There was a statistically significant difference (p < 0.0001) on the total m-ACE score between MCI patients (mean 18.54, SD 3.05) and controls (mean 24.54, SD 2.68). There was also a statistically significant difference between MCI patients and controls on the total score and the fluency, visuospatial, and memory recall sub-scores of the m-ACE (p < 0.05). Performance on the m-ACE significantly correlated with both the Mini-Mental State Examination (MMSE) and the Addenbrooke's Cognitive Examination-III (ACE-III). Using a receiver operator characteristic curve, the optimal cut-off score for MCI on the m-ACE total score was 21 out of 30 (87.5% sensitivity, 84.6% specificity, and 85.5% accuracy). CONCLUSIONS: We validated the Arabic m-ACE in Egyptian patients with MCI and provided objective validation of it as a screening tool for MCI, with good sensitivity, specificity, and accuracy that is comparable to other translated versions of the m-ACE in MCI.

Validation of the Addenbrooke's Cognitive Examination-III in Mild Cognitive Impairment in Arabic Speakers in Egypt.

BACKGROUND AND AIMS: Mild cognitive impairment (MCI) represents an important point on the pathway to developing dementia and a target for early detection and intervention. There is a shortage of validated cognitive screening tools in Arabic to diagnose MCI. The aim of this study was to validate Addenbrooke's Cognitive Examination-III (ACE-III) (Egyptian-Arabic version) in a sample of patients with MCI, to provide cut-off scores in Egyptian-Arabic speakers. METHODS: A total of 24 patients with MCI and 54 controls were included in the study and were administered the Egyptian-Arabic version of the ACE-III. RESULTS: There was a statistically significant difference (p < 0.001) in the total ACE-III score between MCI patients (mean 75.83, standard deviation (SD) 8.1) and controls (mean 86.26, SD 6.74). There was also a statistically significant difference between MCI patients and controls in the memory, fluency, and visuospatial sub-scores of the ACE-III (p < 0.05) but not in attention and language sub-scores. Using a receiver operator characteristic curve, the optimal cut-off score for diagnosing MCI on the ACE-III total score was 81, with 75% sensitivity, 82% specificity, and 80% accuracy. CONCLUSIONS: The results of this study provide objective validation of the Egyptian-Arabic version of the ACE-III as a screening tool for MCI, with good sensitivity, specificity, and accuracy that are comparable to other translated versions of the ACE-III in MCI.

Prevalence and Risk Factors of Urinary Incontinence in Frail Elderly Females.

Background/Purpose. Urinary incontinence (UI) is an important geriatric health problem, and it is linked to frailty syndrome. We had conducted a study to detect the prevalence and risk factors of UI and its effect on quality of life (QOL) among frail elderly females living in Cairo, Egypt. Methods. We carried out a cross-sectional study on 130 frail elderly females sixty years and older, attending Ain Shams Geriatrics Hospital, Cairo, Egypt. Each patient gave oral consent and then was subjected to history taking, full clinical examination, diagnosis of frailty (clinical frailty scale), assessment of UI by the Arabic version of International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), assessment of QOL by using the Arabic version of Incontinence Impact Questionnaire Short Form (IIQ-7 SF), and complete urine analysis. Results. The prevalence of UI among the studied population was 80%. Mixed UI was the most prevalent type. UI was significantly associated with older age, functional impairment, multiparity, osteoarthritis, stroke, vaginal prolapse, and laxative use. All IIQ-7 subscales were higher (worse health-related QOL) for women with mixed UI. Conclusion. Urinary incontinence is prevalent in frail elderly females. Mixed UI, compared with other types, has a significant negative impact on all domains of quality of life.

Validation of the Egyptian-Arabic Version of the Addenbrooke's Cognitive Examination III (ACE-III) in Diagnosing Dementia.

INTRODUCTION: The Addenbrooke's Cognitive Examination III (ACE-III) (2012) is a brief cognitive battery that assesses five sub-domains of cognition (attention and orientation, memory, verbal fluency, language, and visuospatial abilities) which are commonly impaired in dementia. OBJECTIVE: We aimed to validate the Egyptian-Arabic ACE-III in dementia patients, and to provide cut-off scores for the ACE-III in diagnosing dementia in Egyptian-Arabic speakers. METHODS: We included 37 patients with dementia (Alzheimer's disease, n = 25, vascular dementia, n = 8, and dementia with Lewy bodies, n = 4) and 43 controls. RESULTS: There was a statistically significant difference (p < 0.001) in the total ACE-III score between dementia patients (mean 49.81 ± 18.58) and controls (mean 84.84 ± 6.36). There was also a statistically significant difference between dementia patients and controls in all sub-score domains of the ACE-III (p < 0.001). Using a receiver operator characteristic curve, the optimal cut-off score for dementia on the ACE-III total score was 72, (89% sensitivity, 95% specificity, 92% accuracy). CONCLUSIONS: The results of this study provide objective validation of the Egyptian-Arabic version of the ACE-III as a screening tool for dementia, with high sensitivity, specificity, and accuracy comparable to other translated versions of the ACE-III.

Adaptation and Validation of the Mini-Addenbrooke's Cognitive Examination in Dementia in Arabic Speakers in Egypt.

BACKGROUND: The mini-Addenbrooke's Cognitive Examination (m-ACE) is a brief cognitive battery that assesses 5 subdomains of cognition (attention, memory, verbal fluency, visuospatial abilities, and memory recall). It is scored out of 30 and can be administered in under 5 min providing a quick screening tool for assessment of cognition. OBJECTIVES: We aimed to adapt the m-ACE in Arabic speakers in Egypt and to validate it in dementia patients to provide cutoff scores. METHODS: We included 37 patients with dementia (Alzheimer's disease [n = 25], vascular dementia [n = 8], and dementia with Lewy body [n = 4]) and 43 controls. RESULTS: There was a statistically significant difference (p < 0.001) on the total m-ACE score between dementia patients (mean 10.54 and standard deviation [SD] 5.83) and controls (mean 24.02 and SD 2.75). There was also a statistically significant difference between dementia patients and controls on all sub-score domains of the m-ACE (p < 0.05). Performance on the m-ACE significantly correlated with both the Mini-Mental State Examination (MMSE) and the Addenbrooke's Cognitive Examination-III (ACE-III). Using a receiver operator characteristic curve, the optimal cutoff score for dementia on the m-ACE total score was found to be 18 (92% sensitivity, 95% specificity, and 94% accuracy). CONCLUSIONS: We adapted the m-ACE in Arabic speakers in Egypt and provided objective validation of it as a screening tool for dementia, with high sensitivity, specificity, and accuracy.

Effects of age, education, and gender on verbal fluency in healthy adult Arabic-speakers in Egypt.

The objective of this study is to establish the effects of age, gender, and education and to provide preliminary normative data for letter and category fluency tasks in the Egyptian Arabic-speaking population. We evaluated 139 cognitively healthy volunteers aged 20-93 by adapting the letter and category verbal fluency tasks for the Egyptian population. On the letter fluency task, mean number of words generated in one-minute beginning with the Arabic letter "Sheen" (pronounced "sh") was 8.14 words per minute (SD = 3.25). Letter fluency was significantly influenced by education. On category fluency tasks, mean number of animal names generated in one minute was 14.63 words (SD = 5.28). Category fluency was significantly influenced by age and education. We were able identify that age significantly affects category fluency while education significantly affected both letter and category fluency. We were also able to provide preliminary normative data for both tasks in the Egyptian population.

Quality of life in elderly diabetic patients with peripheral arterial disease.

AIM: To study the impact of peripheral arterial disease (PAD) on quality of life and functional status in Egyptian elderly diabetic patients. METHODS: This case-control study included 90 non-demented patients aged 60 years and older. Quality of life assessment was carried out using the Short Form 36 health survey (SF-36), Arterial duplex for diagnosis of peripheral arterial disease; Mini-Mental State Examination, Geriatric Depression Scale, Activity of Daily Living and Instrumental Activity of Daily Living were used. RESULTS: SF-36 domains (except emotional well-being) were significantly affected in diabetic patients with PAD compared with the diabetic patients without PAD. Most of functional assessment items were significantly affected in diabetic patients with PAD compared with diabetic patients without PAD. Increasing PAD severity and presence of PAD symptoms had a significant negative impact on SF-36 scores. Among diabetic complications in PAD patients, cardiovascular disease or stroke significantly affected quality of life. CONCLUSION: PAD significantly affects quality of life and functional status in elderly diabetic patients.