Comorbidities, medications, depression, and physical performance measures associated with severe cognitive impairments in community-dwelling adults.

Cognitive impairment negatively impacts health, psychological, social, and economic domains. Cognitive impairment commonly affects physical functions in older adults, whereas these are deteriorated. However, the prevalence and associated factors of cognitive impairment among community-dwelling adults in Saudi Arabia have not been investigated yet. This study aimed to examine the prevalence of severe cognitive impairment and its associated factors in community-dwelling older adults in Saudi Arabia. This cross-sectional study involved adults aged ≥50 years. Demographic data and clinical data, including number of medications and body mass index (BMI), were collected. Cognitive impairment and depressive symptoms were measured using Arabic versions of the Montreal Cognitive Assessment (MoCA) and Patient Health Questionnaire-9 (PHQ-9), respectively. The participants were divided into severe cognitive impairment and mild cognitive impairment or normal cognitive function groups based on a score of <20 or ≥20, respectively, using the MoCA. Physical measures included dynamic gait index (DGI) scores, timed up-and-go (TUG), 5 times sit-to-stand (5XSST), functional reach test, and 6-minute walk test. A total of 206 participants (female: n = 96) were included. The prevalence of severe cognitive impairment in the community-dwelling older adults was 12.6%. The number of chronic conditions (odds ratio [OR]: 2.31, p<0.001), number of medications (OR: 1.36, p = 0.003), and depressive symptoms using PHQ-9 (OR: 1.11, p = 0.009) were significantly associated with severe cognitive impairment after adjustment for other covariates, including age, sex, and BMI. Based on the physical function measures, only the scores for DGI (OR: 0.86, p = 0.003), TUG (OR: 1.16, p = 0.035) and 5XSST (OR: 1.25, p <0.001) were significantly associated with severe cognitive impairment. This study revealed a high prevalence of severe cognitive impairment among community-dwelling adults in Saudi Arabia. Its major risk factors include depressive symptoms, number of chronic conditions and medications, and physical measures, including DGI, TUG, and 5XSST.

Fatigue and Cognitive Decline Associated With Depressive Symptoms Among Community-Dwelling Adults.

To investigate the prevalence of depressive symptoms in community-dwelling Saudi adults aged ≥50 years and the associated risk factors. Patient Health Questionnaire 9 (PHQ-9) was dichotomized as depressive symptoms when the participants scored ≥10. Risk factors included age, sex, body mass index, education, employment, marital status, number of chronic diseases and medications, fatigue severity scale (FSS), and Montreal Cognitive Assessment (MoCA). Among the 206 participants, the prevalence of depressive symptoms was 17.48%. The number of chronic diseases, medications, and fatigue symptoms were significantly higher in those with depressive symptoms, whereas cognitive functions were significantly lower. Fatigue symptoms and cognitive functions were significantly associated with depressive symptoms. The cut-off scores for risk factors were ≥42 (FSS) and ≤23 (MoCA scale). Fatigue and cognitive impairments were the only risk factors that distinguished participants with and without depressive symptoms.

The Five Times Sit-to-Stand Test is associated with both history of falls and fear of falling among community adults aged 50 years and older.

BACKGROUND: Limited evidence has examined the association between balance and mobility measures with risk of fall. AIM: To determine the prevalence and balance measures associated with falls and fear of falling among community adults aged 50 years and older. METHODS: This cross-sectional study included community-dwelling adults aged ≥ 50 years, living in Saudi Arabia. The participants were asked to report any history of falls in the past 12 months and fear of falling using the Falls Efficacy Scale (FES-I). Balance/mobility measures included the Timed Up and Go (TUG) test, Functional Reach Test (FRT), 10-m walk test (10-MWT), 6-min walk test (6-MWT), and Five Times Sit-to-Stand Test (5XSST). RESULTS: Two hundred and six participants, including 96 women, were included. The prevalence of falls was 12.6%, and the 5XSST was the only balance measure significantly associated with falls (OR 1.17, 95% CI [1.03, 1.33], p = 0.019) with a cutoff score of 13.93 s or more, a sensitivity of 0.73, and a specificity of 0.58. An increase in 5XSST time was associated with an increase in FES-I score, while a decrease in other balance measures (10-MWT, TUG, FRT, and 6-MWT) was associated with an increase in FES-I scores. CONCLUSION: Adults living in Saudi Arabia had a low prevalence of falls. The 5XSST was the only significant balance/mobility measure that distinguished fallers from non-fallers.