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

OBJECTIVES:  To assess the cognitive status of older adults in Saudi Arabia. METHODS:  This was a cross-sectional, multistage, stratified study of older individuals (≥60 years of age) attending primary healthcare centres in Riyadh, Saudi Arabia between January 2015 and April 2017. We collected data using a structured questionnaire, which incorporated questions regarding demographic and anthropometric variables, the Arabic version of Mini-Mental State Examination, the Mini-Nutritional Assessment tool, and the Modified Katz Index of Independence in activities of daily living. RESULTS:  Of the 1299 participants, 914 (70.4%) were male, with a mean age of 66.2 ± 5.9 years. Approximately 79.1% of the participants had intact cognitive function, 17.1 had mild cognitive impairment, and 3.8% had severe cognitive impairment. Impaired cognitive function was associated with increased age, female gender, low education, unmarried status, and unemployed (p less than 0.001). Reduced cognitive impairment was significantly associated with functional impairment and malnutrition (p less than 0.001). CONCLUSION:  Cognitive impairment affected around 21% of the participants. The reduced cognitive function was associated with increased age, female gender, low education level, unmarried, low income, dependency on others, functional impairment, and malnutrition. Such information could motivate health-policy makers to introduce appropriate measures to improve older adults' existing healthcare services in primary care, including cognitive function assessment.

Normative Data for Handgrip Strength in Saudi Older Adults Visiting Primary Health Care Centers.

Background and objective: Handgrip strength (HGS) plays a vital role as a predictor of adverse health outcomes. Several studies have established HGS norms by age, sex, hand, occupation, culture or disability in different countries and for children in Saudi Arabia. However, standardized values for Saudi older adults have not yet been reported. Therefore, the current study was aimed to establish normative data for HGS in Saudi older adults visiting primary health care centers (PHCCs). Material and Method: In this descriptive cross-sectional study, HGS in kilograms was measured using a hydraulic hand dynamometer in Saudi older adults (n = 2045) aged ≥60 years visiting 15 PHCCs selected randomly from the five geographical regions of Riyadh, Saudi Arabia between January 2015 and April 2017. The average mean from three successive trials, standard deviations, and 95% confidence intervals presented for the left and right hands of men and women in six age groups (60-64, 65-69, 70-74, 75-79, 80-84, and 85+ years). The analyses were performed using the ANOVA test for all the age groups and to determine whether any differences exist between them. Results: The average mean HGS was significantly (p < 0.0001) differ by the left and right hands of men and women in six age groups. Conclusions: The current study presents specific norms for HGS in Saudi older adults by age, sex, and hand. Further studies are required to examine the utility of these norms for prediction of morbidity and mortality in this population.

Evaluation of health care services provided for older adults in primary health care centers and its internal environment. A step towards age-friendly health centers.

OBJECTIVES: To evaluate the health care services provided for older adults by primary health care centers (PHCCs) in Riyadh, Kingdom of Saudi Arabia (KSA), and the ease of use of these centers by older adults. METHODS: Between October 2013 and January 2014, we conducted a descriptive cross-sectional study of 15 randomly selected PHCCs in Riyadh City, KSA. The evaluation focused on basic indicators of clinical services offered and factors indicative of the ease of use of the centers by older adults. Evaluations were based upon the age-friendly PHCCs toolkit of the World Health Organization. RESULTS: Coverage of basic health assessments (such as blood pressure, diabetes, and blood cholesterol) was generally good. However, fewer than half of the PHCCs offered annual comprehensive screening for the common age-related conditions. There was no screening for cancer. Counseling on improving lifestyle was provided by most centers. However, there was no standard protocol for counseling. Coverage of common vaccinations was poor. The layout of most PHCCs and their signage were good, except for lack of Braille signage. There may be issues of access of older adults to PHCCs through lack of public transport, limited parking opportunities, the presence of steps, ramps, and internal stairs, and the lack of handrails. CONCLUSIONS: Clinical services and the internal environment of PHCCs can be improved. The data will be useful for health-policy makers to improve PHCCs to be more age-friendly.

Effect of oxidized phosphatidylcholine on biomarkers of oxidative stress in rats.

In this study it was planned to investigate the effect of oxidized phosphatidylcholine (derived from egg) feeding on lipid peroxidation of different tissues in rats. Male Wistar albino rats were fed oxidized and unoxidized phosphatidylcholine for 2 and 4 weeks, respectively. During the period of study food intake and body weights of animals increased gradually. Animals fed oxidized phosphatidylcholine for 2 and 4 weeks showed 33 and 15% spontaneous hemolysis of red blood cells in vitro. Under identical experimental conditions animals given unoxidized phosphatidylcholine showed 14.5 and 13.4% hemolysis for 2 and 4 week's period, respectively. Thiobarbituric acid reactive substances (TBARS) level in thymus, spleen, kidney, heart, liver and lung significantly increased in rats given oxidized phosphatidylcholine as compared to unoxidized group. Furthermore, in oxidized phosphatidylcholine group TBARS values in kidney, liver and lungs continued to rise for 4 weeks of treatment while TBARS level in heart, spleen and thymus was found to be decreased at the end of 4 weeks of oxidized phosphatidylcholine feeding. Plasma triacylglycerol and cholesterol was found to increase in rats who had received oxidized phosphatidylcholine for 2 weeks. These findings suggest that excess and persistent intake of oxidized phosphatidylcholine can cause significant damage to organs.

Impact evaluation of nutrition education intervention for an elementary school in riyadh city.

A nutritional education intervention (NEI) was conducted to assess its impact and suitability for the 5th and 6th graders at a governmental girls' elementary school in Riyadh city. The study design was a randomized posttest only control group. The results revealed that the mean knowledge score of the first posttest for intervention classes was higher than that of their controls (F=91.147, p<0.001). This score increased markedly among all classes at the post-posttest. The mean self-efficacy (SE) score of the control class of 5th graders and intervention class of 6th graders at posttest were much lower than that of their comparable classes and both classes showed significant increase of SE in the post-posttest (paired t=2.819 and 4.561, p<0.01 and p<0.001 respectively). The mean practice score of the posttest was lower among intervention class of the 5th graders than their control, but both means were much higher than that of both classes of the 6th graders (F=6.856, p<0.001). Only control class of the 6th graders showed increased mean practice score at the post-posttest. Stepwise linear regression models reveal that exposure to NEI session was a major predictor of students knowledge at posttest (R(2)=.345). Knowledge score was a predictor of students' dietary SE and practices scores at posttest (R(2)=.041 & .136). Self efficacy was a predictor of students' dietary practices at posttest and post-posttest (R(2)=.107 & .162) as well as lower body mass index (R(2)=.048). The study recommends the replication of such a program among diverse population of school students to have more improvement in students' dietary knowledge, SE and practices.