Background: The use of cognitive assessment tools originally designed for affluent nations in low- and middle-income countries (LMIC) has faced criticism due to potential cultural, educational, and literacy biases. Such adaptations may lead to misclassification and an inflated perception of dementia prevalence. There is a pressing need for further research to create cognitive assessment instruments and dementia diagnosis methods which are suitable as well as practical for clinical application in low- and middle-income countries environments.
Aim: This study aimed to assess the efficiency of the Arabic version of the Saint Louis University Mental Status (SLUMS) examination in a sample of illiterate and low-educated Egyptians in comparison to the Clinical Dementia Rating (CDR) for the detection of cognitive impairment.
Subjects and Methods: We conducted a cross-sectional study that included ninety elderly participants, aged 60 years and above, who attended the Geriatric outpatients' clinic at Ahmed Shawki-Geriatric Medicine Hospital, Ain Shams University Hospitals, Cairo, Egypt. The elderly participants had either normal cognition, mild cognitive impairment or mild dementia, defined as a CDR score of 0-1. Our participants were classified as illiterates, 1-6 years of education, and 7-9 years of education for further analysis. All participants had a comprehensive geriatrics assessment and cognitive assessment with the Arabic version of the CDR and the Arabic version of the SLUMS.
Results: The study showed that the Arabic version of SLUMS had a high sensitivity of 95.4%, but with a low specificity of 38.3% for detection of mild cognitive impairment in illiterate and low-educated Egyptian elderly.
Conclusion: SLUMS is a valid yet not the best tool to screen for cognitive impairment and dementia in the illiterate and low-educated Egyptian elderly.
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