Pattern of Cognitive Impairment Among Community Dwelling Elderly in Egypt and Its Relation to Socioeconomic Status

Abstract

Background Cognitive decline is one of the aging health problems that strongly affects daily functioning and quality of life of older adults and threatening their independence with different levels of cognitive health among people from different socioeconomic groups. Objective To assess the prevalence and pattern of cognitive impairment among community dwelling elderly in Egypt and the contribution of socioeconomic status to inequality in cognitive impairment. Material and Methods This study involved 470 elderly participants ≥ 60 years, males and females. The Montreal Cognitive Assessment (MoCA) was used to assess the prevalence of cognitive impairment, Hachinski ischemic score (HIS) to investigate type of cognitive impairment, Ain Shams Cognitive Assessment (ASCA) to assess pattern of specific cognitive domain affection, and an Egyptian Socioeconomic status (SES) scale was used to describe the SES of participants. Results The prevalence of cognitive impairment was 50.2% that was distributed as 37.7% for MCI and 12.5% for Dementia. The most common type of cognitive impairment was degenerative type (47.8%). Pattern of specific domain affection among cognitively impaired subjects, ranged from 94% for visuospatial function to 12.7% for abstraction. Cognitive impairment was significantly associated with increasing age, female sex, marital status single or widow, low education and with increasing total number of comorbidities and positive family history of cognitive impairment. Cognitive impairment was mainly concentrated in the economically disadvantaged population (low educational level, non-occupied, limited computer use, low income and bad sanitation). Conclusion In Egypt, cognitive impairment is significantly prevalent and concentrated among those who are in low socioeconomic status. Increasing educational level of low SES population and improving their access to healthcare services will help to improve the inequity of cognitive impairment.