The Validation Study of Both the Modified Barthel and Barthel Index, and Their Comparison Based on Rasch Analysis in the Hospitalized Acute Stroke Elderly.

A validation study the Iranian Modified Barthel Index (MBI) in hospitalized acute stroke elderly by classical test theory approach and investigate Rasch analysis for both Iranian version MBI and BI and compare the hierarchical item difficulty of them. Face-to-face interview with 100 geriatric stroke inpatients 60+ or their caregivers was done in a cross-sectional study. First, construct validity of MBI analyzed by the classical test theory, then Rasch analysis were done for BI and MBI. The reliability of the Iranian MBI was significant at 0.955. One factor achieved by the variance of 83.2%. In Rasch analysis for MBI, the most difficult item was stair climbing, whereas the simplest items were bowel and bladder control. In BI, the most difficult items were toilet use and ambulation. The Iranian MBI is very accurate and reliable; therefore the use of MBI to measure better outcomes in stroke elderly inpatients is recommended comparing with BI.

Role of frailty in prediction of hospitalized older adult patient's outcomes: a prospective study

Background/aim: Frailty is associated with an increased risk of negative short-term and long-term hospital outcomes. This study aimed to evaluate the role of frailty in predicting readmission, length of stay, and quality of life in the hospitalized older adults. Materials and methods: This observational study was conducted at Ziaiyan Hospital, Tehran, Iran. In total, 304 participants (65­85 years), were enrolled through the inclusion criteria from August to December 2019. The frailty index (FI) was assessed by the minimum data set-home care. Readmission was obtained through telephone interviews. The length of stay was gathered by the patient's hospital records, and the EuroQol questionnaire was used for assessing the quality of life. Data were collected by a researcher nurse at the admission time, 30, 60, and 90 days after discharge. The logistic regression model and repeated measures ANOVA were employed to analyze the association between frailty and outcomes. Results: According to FI, 102 (33.55%) participants were pre-frail, whereas 35 (11.51%) were frail. In the fully-adjusted model for readmission, the pre-frail participants had a higher risk of readmission at the hospital in comparison with the nonfrail and frail groups (OR = 1.88, 95% CI = 1.90­3.26), and also for GP visits, frail patients showed nearly significant differences (OR = 2.45, 95% CI = 0.99­6.06) but there were no differences between frail and pre-frail patients in readmissions in the emergency ward. In a fully-adjusted prolonged stay model, pre-frail patients had a higher probability to stay longer in hospital (OR = 2.28, 95% CI: 1.24­4.18). The fully-adjusted model for QoL showed, frail patients were more prone to the declined levels of QoL in comparison with pre-frail patients (OR = 10.77, 95% CI: 3.97­29.18). Conclusions: The findings indicated that frailty worsened negative outcomes and declined QoL. Early diagnosis in hospital settings could be beneficial for designing optimal care plans for the frail and pre-frail patients.

Validation of Pain Assessment Checklist for Seniors with Limited Ability to Communicate-II (PACSLAC-II) in Iranian older adults with dementia living in nursing homes.

BACKGROUND: Some dementia patients can self-report pain although the reports are not valid in severe dementia. Observational scales have been developed for pain assessment in these patients. This study aimed to assess the psychometric properties of the Persian version of Pain Assessment Checklist for Seniors with Limited Ability to Communicate-II (PACSLAC-II). METHODS: This validation study was conducted on 138 older adults with dementia suffering from chronic pain who lived in nursing homes. The PACSLAC-II Persian version was applied through observations during activity and rest. Reliability of the PACSLAC-II was evaluated by Cronbach's alpha and intra-class correlation coefficients. Construct validity was determined by confirmatory factor analysis, divergent and convergent validity. The Spearman's rank correlation between PACSLAC-II scores and Faces Pain Scale was calculated for concurrent validity. Known-group validity during activity and rest was calculated by Wilcoxon signed ranks test. RESULTS: Cronbach's alpha coefficient for facial expression (0.82), verbalisation (0.72), and body movement (0.84) subscales indicated good internal consistency. The intra-class correlation coefficients between two raters was 0.76 and in three times evaluation, the value was 0.76. Convergent validity with Iranian Brief Pain Inventory and divergent validity with 15-item Geriatric Depression Scale confirmed the construct validity of PACSLAC-II. Three factors structure of PACSLAC-II was approved, and most of the variance was explained by facial expressions. The PACSLAC-II can discriminate between pain and non-pain events and has a moderate correlation with Faces Pain Scale (r = 0.33). CONCLUSIONS: PACSLAC-II Persian version is a valid and reliable scale for pain assessment in older adults with dementia.

Screening for elder abuse in geriatric outpatients: reliability and validity of the Iranian version Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST).

The present research seeks the notion of the appropriateness of "Hwalek-Sengstock Elder Abuse Screening Test (H-S/East)", and psychometric properties to analyses cultural aspects of elder abuse in the Iranian community dwellers referred to clinics. In this cross-sectional validation study 364 participants, 60 years and over were selected from outpatient' clinics. The SF-36, GDS-15, and AMT scores were used for concurrent validity. The Brief Abuse Screen for the Elderly (BASE) scale was examined to determine the sensitivity and specificity of the Iranian version H-S/East. The elder abuse rate in participants was 29.4% based on cutoff ≥4, while a significant correlation was found in Iranian version H-S/EAST with depression and SF-36 subscale MCS at P < .01, and four factors observed. Optimal cutoff ≥4 obtained with 82.8% sensitivity and 84.5% specificity. It seems the Iranian version of H-S/East demonstrates concurrent validity and fair reliability in elderly outpatients, while construct validity should be carried out in the Iranian elder illiterate population and other languages/cultures.

Geriatric challenges in the new coronavirus disease-19 (COVID-19) pandemic: A systematic review.

Background: During the COVID-19 pandemic, elderly individuals (with the chronological age of 65 years and above) are more susceptible to the SARS-CoV-2 infection complications due to altered immune system response and the higher rate of underlying comorbidities. A vast majority of mortalities are reported in elderly patients; thus, this study aimed to evaluate complications of COVID-19 in elderly patients. Methods: A systematic review was conducted according to MOOSE guidelines. Science Direct, Google Scholar, Scopus, PubMed databases were searched for published articles related to COVID-19 in the elderly up to March 26, 2020. Search MeSh terms included "Severe acute respiratory syndrome coronavirus 2", "2019-nCoV", "SARS-CoV-2", "comorbidity", "elderly", and "geriatrics". Results: In total 1360 potentially relevant articles were screened, of which 35 were relevant and their full texts were considered for the review. Organ damages to the pulmonary system, cardiovascular, liver, and renal system are more prevalent in the elderly with SARS-CoV-2 infection. As the chance of multiorgan involvement is more common among elderly patients, preventive, multidisciplinary, and holistic evaluations are essential to reduce disease consequences. Conclusion: More attention needs to be paid to elderly individuals in the quarantine. Social contact should be made and maintained through online facilities, media, and phone calls to ensure patients' mental health during this stressful situation. Also, they should be provided with enough food and medications by their families or friends. Also, providing social and volunteer services might play an important role in the mental health of those patients who have no social network.

Validity and Reliability of 11-face Faces Pain Scale in the Iranian Elderly Community with Chronic Pain.

BACKGROUND: Accurate pain assessment in elderly population is essential for pain management and nurses have a pivotal role. The 11-face Faces Pain Scale (FPS-11) is a well-established pain assessment measure that has not been validated in the Iranian elderly. AIM: The aim was to study the property assessment of the Iranian version of FPS-11 (FPS-11-IR) among elderly outpatients with chronic pain. METHODS: This is a cross-sectional validation study that conducted in three outpatient clinics in Tehran, Iran, in 2017. Older people aged ≥60 years (n = 217) with chronic knee pain due to degenerative joint disease were participated. The construct validity was examined by applying contrast constructs, and the face validity was determined by rank-ordering test. To assess concurrent validity, the Spearman's correlation coefficient was calculated between the scores of 11-point Numeric Rating Scale (NRS) and FPS-11-IR. Test-retest reliability was determined in 1-week interval. RESULTS: Most of elderly participants (72%) agreed that pain construct displays in faces of the FPS-11-IR and participants" agreement on face rank ordering were vary for each face, ranging from 80% to 100%. Spearman's correlation coefficient between FPS-11-IR and NRS scores was very strong (r = 0.91, P < 0.01). Intraclass correlation coefficient between test-retest scores was 0.96 that indicates excellent reliability. CONCLUSIONS: The FPS-11-IR is a reliable and valid pain assessment scale to use in geriatric patients chronic pain.

Psychometric properties of the Persian version of the nutritional form for the elderly (NUFFE) in nursing home residents.

Background: The Nutritional Form for the Elderly (NUFFE) is a newly developed tool. This study aimed to carry out a psychometric evaluation of the Persian version of NUFFE (NUFFE-P) among nursing home residents. Methods: Nursing home participant's aged ≥ 60 years (n=97) were enrolled. The inclusion criteria were residency for at least 6 months in the nursing home, and ability to communicate. Exclusion criteria included cognitive impairment, having depressed mood, severe hearing loss, problems in upper and lower extremities also, history of hospital admission during 6 months before enrollment. Anthropometric measures, laboratory tests, three-day food intake, NUFFE-P version, Mini Nutritional Assessment (MNA), Barthel Index (BI) and Geriatric Depression Scale (GDS-15) were assessed. The relationship between the NUFFE-P and MNA scores was considered as concurrent validity. Results: The Cronbach's alpha coefficient of NUFFE-P tool was 0.76. The intraclass correlation coefficient for the total score between two raters obtained 0.98 (CI 0.97-0.99). The correlation coefficient between the NUFFE-P and the MNA scores was -0.75 (p<0.01). Four factors were extracted for the NUFFE-P in an exploratory factor analyses. Sensitivity 69.8% and 100% and specificity 75.7% and 85.6% were achieved to detect elderly at medium risk (cutoff=6), and at high risk of under-nutrition (cutoff=11) respectively. Conclusion: The NUFFE-P has sufficient psychometric properties in nutritional status screening among the Iranian elderly nursing homes residents.

Effects of hospital-to-home transitional care on health outcomes of elderly patients in Islamic Republic of Iran.

Background: Hospitalization has a negative effect on the functional and clinical outcomes of elderly patients. Aims: To evaluate the effect of a care transition intervention on functional and clinical outcomes and quality-of-life of elderly patients in the Islamic Republic of Iran after hospital discharge during a 3-month follow-up. Methods: We conducted a randomized controlled trial of 304 elderly hospitalized patients in Tehran from December 2018 to January 2020. The intervention group (n = 152) received care transition intervention and the control group (n = 152) received routine hospital discharge. All patients were assessed during hospital stay and at 30, 60 and 90 days after hospital discharge. Participants were evaluated using the Minimum Data Set-Home Care form, which assesses daily living activity, instrumental daily living activity, cognitive performance, cognition, pain, and depression. Rehospitalization and qualityof- life were evaluated, and differences between the groups and trends in quality-of-life were assessed. Results: Only instrumental daily living activity in the functional outcomes and quality-of-life were greater in the intervention group than the controls. The intervention (odds ratio (OR): 0.11; 95% confidence intervals (CI): 0.01-0.97), age (OR: 1.16; 95% CI: 1.01-1.33), and cognition (OR: 1.24; 95% CI: 1.02-1.51) predicted instrumental daily living activity. Age (coefficient: -0.009, P = 0.001), depression (coefficient: -0.157; P < 0.001), cognition (coefficient: -0.023, P < 0.001) and pain (coefficient: -0.106, P = 0.007) predicted quality-of-life. Conclusion: Care transition interventions can help maintain the independence of older adults after hospital discharge and improve their quality-of-life.

Applicability of SPMSQ in illiterate outpatients in clinics: The validity and reliability of the Short Portable Mental Status Questionnaire.

OBJECTIVES: The Short Portable Mental Status Questionnaire is a brief cognitive tool designed to screen cognitive impairment in geriatric inpatients and outpatients. The validity and reliability of this tool have not been studied in Iran so far. Therefore, this study was conducted to assess the diagnostic properties of the SPMSQ for detection of cognitive disorders in elderly and determine an appropriate cutoff point based on respondents' level of education. METHODS: This cross-sectional study was conducted through face to face interviews on a sample of 156 patients (≥60 years) referred to neurology and geriatric clinics of Ziaiyan hospital, Tehran University of Medical Sciences. Regarding the type of cognitive impairment, Participants were divided into two groups; those with cognitive disorders (n = 96) and healthy (n = 60). The level of literacy was also considered in each of the groups. RESULTS: The Cronbach's alpha coefficient for the SPMSQ was 0.88. In terms of the concurrent validity, a correlation coefficient between SPMSQ and GDS was higher in the literate group compared to the illiterate patients, while in the illiterate group, the SPMSQ had a higher correlation with AMT compared to the other tools. Based on DSM-5, the cutoff point of SPMSQ was 4 in the illiterate elderly patients and the sensitivity and specificity of the tool were at 86.4 and 88.2%, respectively. However, in the literate patients, the cutoff point was 3 and the sensitivity and specificity were 83 and 93.7%, respectively. Also, two components, namely orientation and long-term memory/concentration were determined for the SPMSQ using the factor analysis. CONCLUSION: The Iranian version of SPMSQ has a favorable validity and reliability for diagnosing cognitive disorders and can be used for cognitive screening of illiterate older adults.

The role of acculturation in health status and utilization of health services among the iranian elderly in metropolitan Sydney.

The present study explores the impact of acculturation on health status and use of health and community aged care services among elderly Iranian-born immigrants to Australia. Three hundred two Iranian immigrants aged 65 years and over who had lived in the Sydney Metropolitan area for at least six months participated. Data were collected using a written survey instrument, face-to-face interviews, and telephone interviews. Iranian immigrants had higher levels of psychological distress, more limited physical function, greater need for help or assistance with activities of daily living, lower feelings of wellbeing, and were much less likely to use aged care services than the general population of older Australians. Participants who did not speak English at home were more likely to experience psychological distress and had greater limitations in their physical functioning. Elderly Iranians with better English proficiency had lower levels of anxiety and depressive symptoms and reported less need for help and supervision in activities of daily living; they were also more likely to access health care services. Elderly Iranian immigrants experience higher levels of psychological distress and lower levels of physical function than the general population of older Australians; those with limited proficiency in English are at greatest risk. These findings contribute to the enrichment of multicultural policy, social fairness, access, and equity for ethnic aged people.

Diagnosis of frailty in geriatric patients: Is the pictorial fit frail scale an appropriate screening tool in hospital settings?

BACKGROUND: Frailty is accompanied by serious health complications in the elderly, especially during hospitalization. Visual scales have been designed for quick and easy evaluation of frailty in different cultures and settings. Therefore, this study aimed to define the accuracy of the Pictorial Fit Frail Scale (PFFS) for frailty screening in the hospitalized elderly in Iran. METHODS: This cross-sectional study was conducted on 304 hospitalized participants, aged 65-85 years old admitted at Ziaeian Hospital (Tehran) were enrolled through the inclusion criteria from August to December 2019. All participants were evaluated based on the Minimum Data Set-Home Care, the Pictorial Fit Frail Scale, and the Quality-of-Life instrument, through face-to-face interviews by a trained nurse at the admission time. Spearman's correlation coefficient, and ROC analysis were performed using SPSS at p<0.05. RESULTS: The highest correlation was obtained by Frailty Index (FI) and PFFS (0.770). FI had a negative correlation with QoL (-0.48). The optimal cut-points for PFFS according to FI ≤ 0.08 (robust vs. pre-frail) was obtained 0.10 with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy 100.00% and the best cut-point for PFFS based on FI ≥ 0.25 (pre-frail vs. frail) was obtained 0.29 with sensitivity and specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy 100.00%. CONCLUSION: It seems the Pictorial Fit-Frail Scale (PFFS) is a reliable scale with a high level of accuracy, and excellent sensitivity and specificity to measure the frailty level in hospitalized elderlies.

Validity and reliability of Bayer Activities of Daily Living (Bayer- ADL) scale in the Iranian elderly dementia population: Is there distinguish between illiterate and literate demented in functional dependency?

This validation study is discriminant and concurrent, with the Bayer-Activities of Daily Living (Bayer-ADL) tool among the Iranian elderly dementia illiterate and literate. The tools Bayer-ADL, Global Deterioration Scale (GDS), Mini Mental State Examination (MMSE), ADL-Barthel, and instrumental activities of daily living (IADL) were applied to find Bayer-ADL correlations in 311 dementia outpatients that were ≥60 years old. The Iranian version Bayer-ADL scores between illiterate and literate dementia elderly, based on GDS, observed good discrimination values (0.923 sensitivity and 0.750 specificity) in illiterate people, and excellent discrimination values were achieved (sensitivity 0.919 and 0. 986 specificity) in literate dementia elderly. The suggested cutoff points were 1.79 for illiterate and for the Iranian literate dementia elderly 1.82, based on GDS. Both forms (24 and 25 items) of Bayer-ADL were correlated to GDS, ADL, and IADL. Bayer-ADL is a valid tool to distinguish physical dysfunction between illiterate and literate of the Iranian dementia elderly; however, some revisions in the components are needed for the illiterate elderly. Generally, the findings presented in the Iranian version Bayer-ADL could be useful to both clinical purpose and international studies.

Evaluation of the effectiveness of Persian diabetes self-management education in older adults with type 2 diabetes at a diabetes outpatient clinic in Tehran: a pilot randomized control trial.

PURPOSE: The effectiveness of diabetes self-management interventions has been more generally demonstrated in adults, but there is little evidence of diabetes self-management specific to older adults situated in Iran. The purpose of this study was to evaluate the effectiveness of Persian Diabetes Self-Management Education on self-efficacy, quality of life, self-care activity, depression and loneliness in older adults with type 2 diabetes. METHODS: In pilot randomized controlled trial, a total of 34 participants ≥60 years with type 2 diabetes were randomly assigned into intervention (n = 17) and control (n = 17) group in an outpatient diabetes clinic in Tehran. To assess the primary outcome of participant experiences, the Diabetes Management Self-efficacy Scale (DMSES) was the method of measurement. The Diabetes Quality of Life-Basic Clinical Inventory (DQoL-BCI), Patient Health Questionnaire-9 (PHQ-9), Diabetes Self-Management Education Scale (DSMES), and adult Social-Emotional Loneliness Scale Short form (SELSA-S) were used as secondary outcomes. Participants' evaluations were completed at baseline, while measurements were conducted two and four weeks after allocation, using repeated measurements of Univariate and multivariate ANOVA (adjusted for baseline values) to analyze the data. RESULTS: In the multivariate model, there was a significant difference between the control and intervention groups regarding reported quality of life (p = 0.04) and the medical-domain's reported self-efficacy (p = 0.02). However, there were no significant differences in the reported self-management, depression, loneliness, as well as the other domain of self-efficacy; as compared between the two groups before and after intervention. CONCLUSION: The study depicts a promising impact on older adults, imparted by the pertinent program. The finding showed PDSME has a positive effect on quality of life and medical control domain of self-efficacy. This pilot study showed that the program is feasible and duly beneficial if delivered to older adults. This pilot proves appealing to begin further testing within a larger sample population.

Iranian Version of Barthel Index: Validity and Reliability in Outpatients' Elderly.

BACKGROUND: Validation study of Barthel Index for elderly patients being attended in outpatient and rehabilitation clinics in Iran. METHODS: Face-to-face interview with 395 out patients geriatric 60+ years was done in a cross-sectional study. The internal consistency Barthel-ADL was used to approve reliability. Criterion validity and factor analysis were used to verify validity. RESULTS: Reliability the Iranian version BI was significant at 0.938. In criterion validity analysis, the high correlation tools included Functional Ambulation Category (FAC) and Foot and Ankle Ability Measure (FAAM-subscales ADL) at 0.947 and -0.945, respectively. In factor analyses, two domains obtained, the variance of 10 items achieved 69.79%; also, the Item Total Correlation (ITC) of each item was measured. CONCLUSIONS: The Barthel Index shows a good validity and reliability, and recommended to use in the Iranian geriatric outpatients in evaluating physical ability.

Comparison of Two Validation Nutrition Tools in Hospitalized Elderly: Full Mini Nutritional Assessment and Short-form Mini Nutritional Assessment.

BACKGROUND: The aim was to determine validity, reliability, and cutoff of full-mini nutritional assessment (MNA) and MNA-short form (SF) also which one was better for the screening of malnutrition in the Iranian hospitalized elderly. METHODS: In this cross-sectional validation study, 96 hospitalized elderly ≥60 years selected from two hospitals in Tehran. Anthropometric measures (body mass index [BMI], mid-arm circumference [MAC], calf circumference [CC], abdomen, and waist skinfold thickness) and laboratory tests (albumin and hemoglobin levels, and red blood cell count were performed. Nutrition tools (full-MNA and MNA-SF), cognition tool (mini-mental state examination, depression scale (Geriatric Depression Scale15 and activities of daily living (ADL) index (Modified Barthel-ADL) were administered. RESULTS: The full-MNA scores were significantly correlated to measures of MAC, BMI, waist, and CC. The MNS-SF scores were significantly related to measures of MAC, waist, and CC. Serum albumin showed a poor correlation with both tools. At cutoff 24 in full-MNA had a sensitivity 75% and specificity 77.8% and the MNA-SF considered 62.5% sensitivity and 65.3% specificity at cutoff 10.50 to detect well-nourished from malnourished subjects. The internal consistencies of both tools were >90%. In exploratory factor analysis, six components found for full-MNA and two components for MNA-SF. Known group validity of full-MNA was reflected significant differences between geriatric patients with expected higher full-MNA scores and patients with expected lower scores (BMI ≥24 vs. BMI <24 or bed ulcer or assisted food intake). CONCLUSIONS: It seems the Persian version of full-MNA is more appropriate in comparison to MNA-SF for screening malnutrition in the Iranian hospitalized elderly patients.

Iranian Brief Pain Inventory: Validation and Application in Elderly People With Cancer Pain.

CONTEXT: Cancer is a major health problem in the elderly, and pain is one of the most common symptoms among older patients with cancer. Sufficient pain treatments depend on the accuracy of the pain assessment tool. OBJECTIVES: This study aimed to assess the psychometric properties of the Iranian version of the Brief Pain Inventory (BPI-IR) among elderly individuals with cancer. METHODS: This validation study was conducted with 368 people aged 60+ years old who were undergoing oncology treatments. The BPI-IR was applied to the elderly participants through face-to-face interviews. Reliability of the BPI-IR was evaluated using Cronbach's alpha coefficient and intraclass correlation coefficient between test-retest scores. Criterion validity was determined by calculating the Spearman's correlation coefficient between scores on the BPI-IR and those on the SF-36 physical function, Activities of Daily Living, Instrumental Activities of Daily Living, Center for Epidemiological Studies Depression, Patient Pain Questionnaire, and Symptom Distress Scale. Construct validity of the BPI-IR was evaluated using exploratory factor analyses. RESULTS: Cronbach's alpha coefficient was calculated to be 0.94, and the intraclass correlation coefficient between twice the BPI-IR scores over two weeks obtained was 0.89. There were moderate-to-high correlations between the BPI-IR and the Patient Pain Questionnaire (r = 0.886), Symptom Distress Scale (r = 0.492), SF-36 physical function (r = 0.554), and Center for Epidemiological Studies Depression (r = 0.608). Two factors were extracted in exploratory factor analyses, and they explained 73.86% of total variance. CONCLUSION: The BPI-IR is a reliable and valid tool for assessing pain among older adults with cancer.

Prevalence of Dementia and Associated Factors among Older Adults in Iran: National Elderly Health Survey (NEHS).

BACKGROUND: The prevalence of cognitive impairment and dementia is increasing in Iran and the world. There is no study available on the prevalence of dementia at the national level in Iran. This study aimed to report the rate of dementia at the national level in Iran. METHODS: The National Elderly Health Survey (NEHS) was a cross-sectional study with multistage cluster random sampling on people aged ≥ 60 years in Iran. Dementia was diagnosed by trained general practitioners using Brief Cognitive Assessment Tool (BCAT). In this study, the dementia diagnosis rate was considered as the ratio of individuals previously diagnosed with dementia to individuals considered as dementia. Analyses were carried out using survey analysis method. The provincial rates were standardized based on the Iranian population in 2011 and the national rate was standardized based on WHO standard populations. Association between risk factors and dementia was assessed using a multivariable logistic regression model. RESULTS: The overall crude prevalence of dementia among people aged ≥ 60 years was 7.9% (8.7% in women and 6.9% in men) and age standardized dementia prevalence rate in Iran based on WHO standard population was 8.1% (9.6% in women and 6.5% in men). The prevalence of dementia was observed as 3.7% among people aged 60-64 years, 6.2% in the age-group 65-69 years, 10.4% in the age-group 70-74 years, 14.4% in the age-group 75-79 years, and 13.0% in the age-group ≥ 80 years. West Azerbaijan had the lowest and North Khorasan had the highest age-sex adjusted prevalence rate of dementia. Our results indicated that only 21.2% of subjects with dementia were diagnosed. We observed that diabetes mellitus, depressed mood, illiteracy, and increased age were associated with dementia. CONCLUSION: It seems that dementia is more common in Iran than many other countries. However, the rate of dementia diagnosis is much lower than that in developed countries.