Purpose: Many elderly are concerned about falling transfer to assisted living facilities (ALF). Previous literatures studied the medication use and falls in the community, hospitals, or nursing homes, with scanty data about ALF. Therefore, the aim of the current case-control study was to assess the relation between medication use and falls among elderly in ALF. Methods:A matched case-control study was conducted. The study was conducted in ALF in Cairo, Egypt. The study participants were 188 individuals; they were subdivided into two groups: fallers and nonfallers; timed up and go test (TUGT) was performed by all subjects. Medication data were collected according to the fall riskincreasing drugs list and the list of drugs that cause or worsen orthostatism. Other fall risk factors, as suggested by American Geriatric Society, were assessed.Results: The use of vasodilators, diuretics, alpha blockers, opioids, antipsychotics, and sedative hypnotics were more common in fallers than in nonfallers (P < 0.001, P = 0.03, P < 0.001, P = 0.013, P < 0.001, and P < 0.001, respectively). Vasodilators, alpha blockers, and antipsychotics were significant predictors of falls even after adjustment for the possible confounding factors. Vasodilators, alpha blockers, opioids, sedative hypnotics, and recent dose changes in oral hypoglycemics were significant predictors of higher TUGT after adjustment for the possible confounding factors. Conclusion:The current study supported the risk of psychotropic and cardiovascular medications, with especial emphasis on vasodilators, alpha blockers, and antipsychotics, with raising concern about opioids, sedative hypnotics, and recent dose change in oral hypoglycemics.

BackgroundHypertension prevalence increases with age, and is a readily treatable risk factor for the most common causes of morbidity and mortality in older age: stroke, ischaemic heart disease, renal insufficiency and dementia (Ferri et al .,2011)(1).Hypertension is the leading risk factor for mortality and the third cause of disability world wide .by the year 2025, it is estimated that there will be 1.65 billion patient with hypertension (Ezzati et al.,2002)(2). Medication adherence is defined as the extent to which a person's behavior agrees with the agreed medication regimen from a health care provider. (leporini et al.,2014)(3). Addressing the issue of adherence in hypertensive patients focuses on three major issues: effective measurements of adherence, prevalence and predictors of adherence, and effective strategies for improving adherence.( Hovstadius ,2011)(4). Reasons for nonadherence can be broadly classified into patient factors, medication factors, health care provider factors, health care system factors, and socioeconomic factors( sabate ,2003)(5). Potential causes for Non-Adherence include Complex medication regimens ,Convenience factors (eg, dosing frequency),Behavioral factors,Treatment of asymptomatic conditions, affordability , Side effect profiles of medications, Severity of the problem, Patient disagreeing with therapeutic plan .( Munger et al.,2007)(6). Poor adherence may have a major effect on clinical outcome, lead to notable worsening of disease, increased health care costs and even death ( Pasina et al., 2014)(7) Several studies done on the prevelance of non- AbstractBackground: Hypertension is an important publi c health challenge worldwide. Non -adherence to antihypertensive treatment is a big obstacle in blood pressure control and predispose to disease progression to complications.

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There is evidence consistent with the hypothesis that genetic, inflammatory and immune mechanisms are involved in the pathogenesis of AD. The aim of this study is to assess the relationship between Apolipoprotein E (Apo E), serum levels of inflammatory markers, and cognitive functions among elderly patients with Alzheimer’s disease (AD) and Mild cognitive impairment (MCI) compared to elderly with normal cognitive function. 88 participants (≥60 years) from Ain Shams University Hospital were enrolled. They were divided into 3 groups: Group A (32 elderly patients with AD), Group B (32 elderly patients with MCI) and Group C (24 controls with normal cognitive function). All participants were subjected to comprehensive geriatric assessment, Apo E genotyping, measurement of C-reactive protein (CRP) and Alpha-1-antichymotrypsin (ACT), by PCR-RFLP, ELIZA and semi-quantitative method respectively. The most common variant of Apo E gene was E3/E3 being more frequent in healthy control group (HC) than the other two groups and the least common variant was E4/E4 detected only in the AD group. ApoE4 allele was associated with 40.6% of AD patients (where 31.4% were heterozygous and 8.6 % homozygous) and 17.1% of MCI patients, whereas ApoE2 was more prevalent in the control group (P<0.05). A significant difference was observed when Mini mental status Examination (MMSE) score in different Apo E alleles was compared (P<0.01). The highest score was associated with (E2/E3) allele whereas, the lowest score was associated with (E4/E4) allele. Regarding inflammatory markers; CRP levels showed a statistically significant difference between the 3 groups and were higher in the AD group than the other 2 groups. (P<0.01). There was no statistically significant difference between the 3 groups as regard ACT level (P>0.05). Carriers of at least one E4 allele showed great risk to develop AD when combined with high CRP serum levels (OR = 36; CI: 11.4-113.7; P< 0.01). In conclusion, Apo E together with CRP may be a useful tool to predict Alzheimer’s disease.