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Background Early symptoms of dementia may not be apparent and are sometimes even concealed during short office visits initiated for other complaints. The aim of the study is to find out if the combined use of VF/CDT, VF/BNT, or CDT/BNT could improve the accuracy of detecting mild NCD in an outpatient setting, compared with either test used alone. Participants Community-dwelling older adults, attending the outpatient Geriatrics Clinic at Ain Shams University hospitals between June 1, 2017 and January 31, 2018. All participants received a comprehensive geriatric assessment (CGA) which included the mini-mental state examination test. Participants with a score of less than 24 and fulfil DSM5 criteria for mild neurocognitive disorder (NCD) are considered cognitively impaired otherwise are considered normal. Then participants were further examined by the Arabic versions of CDT, BNT, and VF animal category. Results We recruited 143 male and female participants mean age 67.17 ± 5.41, females are 56.6%, and 48.9% of all participants have mild NCD according to DSM5 criteria. AUC for individual neurocognitive tests in illiterates is 0.893 for clock drawing test, 0.907 for verbal fluency animal category, and 0.904 for Boston naming test, while AUC for neurocognitive test combinations in illiterates is 0.932 for VF + CDT, 0.917 for VF + BNT, and 0.932 for BNT + CDT. On the other hand, AUC for individual neurocognitive tests in educated participants is 0.925 for clock drawing test, 0.921 for verbal fluency animal category, and 0.907 for Boston naming test, whereas AUC for neurocognitive test combinations in educated participants is 0.958 for VF + CDT, 0.963 for VF + BNT, and 0.953 for BNT + CDT. Conclusion From the current study, we can conclude that any of the studied combinations have better diagnostic accuracy (although small) than individual test in both literate and illiterate older adults.

Background: Little is known regarding the standardized neuropsychological tests available in Arabic. The aim is to determine the diagnostic performance and the best cutoff value for the clock drawing test (CDT), animal category test of semantic verbal fluency (VF), and the short form of the Boston Naming Test (BNT) in identifying patients with mild and major neurocognitive disorders among community-dwelling educated Egyptian older adults using Arabic versions of those tests. Community-dwelling educated male and female older adults aged 60 years or older. Successive patients were attending the outpatient geriatrics clinic at the Ain Shams University Hospital during a 12month study period from January to December 2016. The study was approved by the ethics committee of the Faculty of Medicine, Ain Shams University, Cairo, Egypt. Informed consent to participate in the study was received from each participant and/or his/her next of kin. Patients and/or their next of kin who declined to participate were excluded, as were those who refused to complete the assessment. A two-step protocol was followed.Step 1: Participants were divided into three groups according to DSM-V diagnostic criteria for neurocognitive disorders. The assessment of cognitive function included Mini-Mental State Examination (MMSE), Clinical Dementia Rating Scale (CDR), patient's current functional status regarding basic and instrumental activities of daily living by the Blessed Dementia Scale (BDS), and patient detailed history and examination based on protocol five of the CERAD assessment packet.Step 2: The application of the Arabic versions of ELokl et al. 2001 VF test, the BNT, and the CD by a clinical psychologist blinded to the initial assessment results. Results: In current study, AUC for CD, VF, and BN are 0.807, 0.77, and 0.753 respectively for mild NCD and 0.884, 0.877, and 0.839 respectively for major NCD while cutoff values for CD, VF, and BN are 2, 12, and 14 respectively for mild NCD and 2, 9, and 13 respectively for major NCD. Conclusion: Verbal fluency, clock drawing, and Boston naming showed reasonable diagnostic performance in educated Egyptian elderly and should be considered separately or in combination for the assessment of cognitive function. Further research is warranted.

Background Sarcopenia is highly prevalent among elderly patients with hip fracture. Studies reported a significant association between sarcopenia and clinical outcomes in patients with hip fractures. The current study aimed to determine the prevalence of sarcopenia among elderly patients with hip fracture and its effect on short-term functional outcomes, highlighting predictors of postoperative functional decline. Methods This is a cross-sectional study followed by a prospective cohort. Elderly patients (60 years and above) with hip fractures were recruited from the orthopedic department. Patients were followed by the ortho-geriatric team in the perioperative period and for three postoperative months. Patients were subjected to comprehensive geriatric assessment including a full history and physical examination. In the preoperative state and after three months of follow-up the following were assessed: functional independence using the Barthel index (BI); nutritional state using a checklist named DETERMINE Your Nutritional Health ; sarcopenia using the SARC-F questionnaire assessing strength, ambulation, rising from a chair, climbing stairs, and fall history. Perioperative risk assessment and post-discharge care were obtained through medical records and by questioning patients or families. Preoperative sarcopenia was confirmed using the Ishii equation which is an equation that includes (age, calf circumference, and hand grip strength). Results Preoperative sarcopenia screening showed that 29.3% of patients suffered sarcopenia by SARC-F questionnaire and 28.6% by Ishii equation score. At the end of the follow-up, 57.9% of patients suffered sarcopenia by SARC-F questionnaire. There was a marked post-fracture decline in independence level; 52.1% had slight dependence in function, 27.1% had moderate dependence in function, and 20.7% had total dependence in function. Conclusion This study gives us the chance for a greater understanding of the negative effects of sarcopenia on the outcomes following hip fracture surgery in the geriatric population. It shows a prevalence of sarcopenia among the elderly with hip fractures at 29.3%. The elderly experience a marked post-fracture decline in their level of independence concerning basic activities of daily living. Those with older age, higher comorbidities, cognitive impairment, and functional dependence with poor nutritional state are more vulnerable to functional decline. Other perioperative risks include delayed surgery, surgery type, postoperative complications, longer hospital stays, lack of planned rehabilitative and nutritional plans, and postoperative depression. Early detection of sarcopenia helps establish early interventional plans to reverse such poor outcomes.