Background: Cognitive impairment should be accurately assessed in the elderly. The presence of a valid Arabic version of the SLUMS Examination would allow better diagnosis of cognitive impairment as it considers different educational levels prevalent in the Egyptian community. Aim: To assess the reliability and validity of the Arabic version of Saint-Louis-University-Mental-Status (SLUMS) Examination for cognitive impairment and to estimate the prevalence of cognitive impairment among community dwelling Egyptian older adults. Materials and methods: This study was conducted in two phases: phase I, during which reliability and validity of the Arabic version of SLUMS Examination was assessed; then phase II, where the prevalence of cognitive impairment among community dwelling Egyptian elders was estimated using the Arabic version of SLUMS Examination. Results: The phase I of the study was conducted on 90 elderly group for testing validity and reliability of the SLUMS tool. A statistically significant agreement was evident between SLUMS Examination and Mini Mental State Examination MMSE (Kappa 0. 826, P <0.001). Sensitivity of SLUMS Examination was 94% (31/33) while Specificity was 96% (55/57). SLUMS Examination was also found to be reliable by test-retest. (McNemar P>0.05, Kappa 0.806 P<0.001). The internal consistency of the Arabic version of SLUMS Examination on the main items of cognitive function showed a Cronbach's alpha of 0.723 with a significant item-to-item and item-to-total correlation. The phase II of the study was conducted on 284 elderly. 51.4% of them demonstrated mild neuro-cognitive disorder and 5.6% were demented. Age showed a significant relationship with cognitive function level (P<0.001). Education level, employment and depression showed significant differences between elders with normal cognitive function and the demented (P<0.001, P=0.003 and P <0.001 respectively). Conclusion: The Arabic version of SLUMS-Examination was found to be a valid and reliable screening tool for cognitive impairment in elderly. Almost half of the community dwelling Egyptian elderly showed mild neurocognitive disorder and a minority were demented. Older age, less education, unemployment and evidence of depression were found to be significantly associated with cognitive impairment. The Arabic version of SLUMS-Examination should be included in the routine assessment of cognitive impairment in Egyptian elders.

Background: Older patients are now the rule rather than the exception in hemodialysis (HD). Cognitive impairment is common among persons with end stage renal disease (ESRD) and is associated with poor outcomes. Aim: To assess the prevalence of cognitive impairment among older adults on HD and the association of different patients' demographics and characteristics with cognitive impairment. Materials and methods: A cross section study was conducted to assess the cognitive functions of elderly subjects on HD. 94 subjects, 60 years old and above, were included. All subjects were subjected to: 1-comprehensive geriatric assessment. 2-Laboratory investigations including: hemoglobin, serum creatinine, serum urea, serum potassium, serum sodium and serum albumin. Kt/V as a marker of dialysis adequacy was calculated. Results: The study revealed that 26 (27.7%) patients had normal cognitive function, 32 (43%) had mild cognitive impairment, 21 (23%) had mild dementia, 8 (8.5%) had moderate dementia and 7 (7.4%) had severe dementia. Older age, low education level and longer duration of dialysis history were found to have significant associations with cognitive impairment, [P: < 0.001, 0.002, and 0.012 respectively]. While hemoglobin, serum albumin, serum creatinine, serum urea, serum potassium and Kt/V showed no significant association with cognitive impairment, Serum sodium and dry weight dialysis showed significant difference between patients with normal cognitive function and patients with cognitive impairment, [P <0.001 both]. Conclusion: Cognitive impairment is prevalent in Egyptian older adults on HD and more prevalent and severe in those with older age, low education, lower level of serum sodium, longer duration of dialysis history and higher dry weight.

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Background: Community-acquired pneumonia (CAP) is an acute disease that causes high mortality in the elderly, and is a common cause of medical admission. Poor prognostic factors of CAP include advancing age, multiple co morbid illnesses, poor premorbid functional status and severity of pneumonia. Objectives: A prospective observational study was conducted to determine the predictors of outcomes of (CAP) in Egyptian older adults. Subjects and Methods: 170 elderly patients; 72 males and 98 females were recruited from Ain Shams University Hospitals, diagnosed with CAP and required admission to the hospital for treatment. Tools applied were: Comprehensive Geriatric Assessment, Pneumonia Specific Risk Index (PSI), CURB-65, The Charlson Comorbidity Index (CCI), and Barthel Index (BI). Results: CURB 65 and PSI showed significant differences for all the outcomes (length of stay, ICU admission, ventilation and mortality). Using the logistic regression analysis, BI was found to be a significant predictor for the length of hospital stay (