The prevalence of mild cognitive impairment (MCI) and Alzheimer disease (AD) have not been well been studied in Arab populations. In a door-to-door study of all residents aged ≥65 years in Wadi-Ara, an Arab community in northern Israel, we estimated the prevalence of AD, MCI and the risk of conversion to AD. Subjects were classified as cognitively normal, MCI, AD or other based on neurological and cognitive examination (in Arabic). MCI subjects were re-examined (interval ≥1 year) to determine conversion to AD and contributions of age, gender and education to the probability of conversion. Of the 944 participants (96.6% of those approached; 49.4% men), 92 (9.8%) had AD. An unusually high prevalence of MCI (n=303, 32.1%) was observed. Since the majority of women (77.2%) had no schooling, we estimated the effect of gender on the risk of AD and MCI among subjects without schooling and of school years among men. Among subjects with no schooling (n=452), age (p=0.02) and female gender (p<0.0001) were significant predictors of AD, whereas risk of MCI increased only with age (p=0.0001). Among men (n=318), age increased the risk (p<0.0001), school years reduced the risk of AD (p=0.039) and similarly for MCI [age (p=0.0001); school years (p=0.0007)]. Age (p=0.013), but not gender or school years, was a significant predictor of conversion from MCI to AD (annual rate 5.7%). The prevalence of MCI and AD are unusually high in Wadi Ara, while the rate of conversion from MCI to AD is low. Yet unidentified genetic factors might underlie this observation.

Education and gender influence performance when using the Arabic translation of the MMSE and BCST in cognitively normal elderly. Cognitively normal females with 0-4 years of education scored lower than males. These results should be taken into consideration in the daily use of these instruments in Arabic.

The prevalence of ET in Arabic villages of Wadi Ara is low.

Background: We aimed to determine whether vascular risk factors are associated with Alzheimer’s disease (AD) and mild cognitive impairment (MCI) in an elderly Arab population. Methods: An Arabic-speaking team performed a door-to-door survey of consecutive residents aged ≧65 years. We estimated the odds of AD or MCI versus normal controls as a function of age, gender, education and presence of vascular factors by multinomial logistic regression with interactions. Results: Out of 767 subjects (54% men), 444 were cognitively normal, 234 had MCI and 89 had AD. AD was significantly associated with hypertension (p = 0.01; OR = 2.08; 95% CI: 1.18–3.65), age (p < 0.0001; OR = 1.19; 95% CI: 1.14–1.24), female gender (p = 0.0016; OR = 3.06; 95% CI: 1.53–6.15) and education (p = 0.0002; OR = 0.75; 95% CI: 0.65–0.88). MCI was significantly associated with hypertension (p = 0.0042; OR = 1.69; 95% CI: 1.25–2.44), age (p < 0.0001; OR = 1.06; 95% CI: 1.03–1.09) and education (p < 0.0001; OR = 0.76; 95% CI: 0.71–0.83), but not with gender. Conclusions: Hypertension, older age and low education significantly increase the probability of AD and MCI. The effect of hypertension on the odds of AD versus controls is over and above the effects of age, gender and education. For MCI versus controls there is no gender effect, and the effect of hypertension is over and above the effects of age and education.

Essential tremor (ET) is much more prevalent than Parkinson's disease (PD) in Western countries. We estimated ET and PD prevalence in Wadi Ara Arabic villages in Northern Israel.In this door-to-door survey, all consenting residents aged ≥ 65 years were systematically examined by an Arabic speaking team. No pre-screening questionnaires were used. A random sample of 900 subjects [437 males, mean age (SD)=72.6 years(6.6)] of the 2,163 eligible residents were evaluated. Sixteen subjects had an action, intentional tremor. Tremor prevalence was estimated as 1.78 % (95 % CI 1.1-2.87). Nine of these had another likely cause of tremor. Only 7 were diagnosed as ET [prevalence 0.78 % (95 %CI 0.38-1.6)]. PD was diagnosed in 13 subjects. PD prevalence was 1.44 % (95%CI 0.84-2.45).ET is unusually uncommon in this population and possibly even less frequent than PD. PD prevalence in Wadi Ara is similar to that reported in Western countries.