Dementia in Eastern Mediterranean countries: A systematic review

Abstract

Globally, there is an increase in the older population, whose lives are affected by local cultural norms. In Eastern Mediterranean countries, dementia is conventionally hidden from view with few dedicated services or recognition for diagnosis. The aim of this systematic review is to explore the limited literature on dementia and cognitive impairment among older people in Eastern Mediterranean countries to present an evaluation of current practices and to consolidate knowledge for future planning. Thirty-three studies were identified for inclusion in the review, and four themes were apparent. Firstly, prevalence, comorbidity and gender: In Eastern Mediterranean countries, many studies identify that the prevalence of dementia is high. As is the case elsewhere, many older adults in Eastern Mediterranean countries have at least one coexisting long-term condition, and some experience low life-satisfaction. Secondly, culture: In Eastern Mediterranean countries, the older adult is highly respected, and placement outside of the family home is considered an abandonment of family duty. The term dementia carries stigma, and it is widely believed that dementia is caused by 'fate'. Thirdly, recognition and tools: There is a lack of verified assessment instruments to assess for dementia. Despite concerns about the cultural appropriateness of the Mini-Mental State Exam, particularly for people who have low literacy levels, and low literacy being the norm in Eastern Mediterranean countries, the Mini-Mental State Examination is the main assessment instrument. Translation and transition of non-Arabic assessment instruments and tools with psychometric properties presents a challenge for clinicians. Finally, workforce issues: health care workers lack knowledge about dementia, as dementia care is a relatively recent addition to the nursing and medical syllabi. While there were some inconsistencies in the papers published, many of the articles call for increasing educational programmes and health and social care policies to promote improved and practical gerontological nursing and medicine. Health care professionals need education about sociocultural, religious, and language needs to deliver improved culturally sensitive care.

Hospital staff members' preferences about who should be prioritized to receive the COVID-19 vaccine: People with or without Alzheimer's disease?

“…These results are not surprising in terms of what they reveal about differences in Jewish/Arab perspectives: Compared to the Jewish population, the Arab sector in Israel is characterized by stronger social relationships and a higher commitment to providing care for family members ( Abdullah, 2016 , Ayalon, 2018 ). Furthermore, Arab society tends to put a relatively greater emphasis on caring for elderly people in general, and for those with cognitive decline in particular ( Yaghmour, Bartlett, & Brannelly, 2018 ). Regarding susceptibility to contracting COVID-19, compared to participants who perceived themselves as having a low risk of contracting COVID-19, those who perceived themselves as having a medium-high risk of contracting COVID-19 preferred giving the vaccine first to Samuel (an older patient without AD).…”

Dementia caregiving in the Middle East and North Africa: A scoping review

“…Although no date restrictions were imposed during the search in this study, all the articles included in the scoping review were produced within the past two decades, the earliest being from 2001 with an upward trend in publications throughout that period. Half of the studies (Abyad, 2015;Abyad & Hammami, 2016;Alshammari et al, 2017;Chaaya et al, 2017;Hussein & Ismail, 2017;Khusaifan & El Keshky, 2017;Phung et al, 2017;S eoud & Ducharme, 2015;Yaghmour et al, 2016Yaghmour et al, , 2019 (n ¼ 10) were published within the past five years, with a notable peak in publications occurring in 2017 when a quarter (n ¼ 5) of all studies about dementia care were published. This may indicate that in the absence of any cure, caregiving is beginning to be recognized as an important dimension in the management of dementia.…”

Pharmaceutical care in Alzheimer's disease

“…The majority of people with AD are older than 65 years, and they are more likely to have comorbid conditions such as cardiovascular diseases and diabetes (11)(12)(13). Comorbidities often require long-term use of medications which increase the risk of DRPs, including cognitive impairment in patients with AD.…”