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Objective: To determine the diagnostic accuracy of the Addenbrooke’s Cognitive Examination Revised (ACE-R) as a cognitive screening tool for older adults with low levels of schooling and healthy aging, MCI and dementia in Brazil. Methods: All participants underwent neurological and psychiatric examinations and were administered a validated version of ACE-R. Results: A total of 85 participants were evaluated; most were females (84.7%, n = 72). The post hoc analysis showed statistical differences in ACE-R total scores between older adults with mild cognitive impairment (MCI) and controls (p < 0.001) and in subitem scores including verbal fluency, language, visuospatial skills and attention (p < 0.001). The visual-spatial skills subitem was the most strongly correlated with schooling level (r = 0.509, p < 0.001), whereas late, immediate recall and recognition memory were not influenced by schooling. The ACE-R had the best diagnostic accuracy in discriminating between MCI and controls = 0.69 (

Background COVID-19 outbreak has been accompanied by a massive infodemic, however, many vulnerable individuals such as illiterate or low-literate, older adults and rural populations have limited access to health information. In this context, these individuals are more likely to have poor knowledge, attitudes, and preventive practices related to COVID-19. The current study was aimed to investigate COVID-19’s awareness of the illiterate population of Pakistan. Methods A cross-sectional survey was conducted among illiterate Pakistanis of ages ≥ 18 years through a convenient sampling approach. The study participants were interviewed face to face by respecting the defined precautionary measures and all data were entered and analyzed using SPSS version 22 (IBM, Armonk, NY). Results The mean age of the study participants’ (N = 394) was 37.2 ± 9.60 years, with the majority being males (80.7%). All participants were aware of the COVID-19 outbreak and television news channels (75.1%) were the primary source of information. The mean knowledge score was 5.33 ± 1.88, and about 27% of participants had a good knowledge score (score ≥ 7) followed by moderate (score 4 - 6) and poor (score ≤ 3) knowledge in 41.6%, and 31.5% of respondents, respectively. The attitude score was 4.42 ± 1.22 with good (score ≥ 6), average (score 4 - 5), and poor attitude (score ≤ 3) in 19%, 66%, and 15% of the participants, respectively. The average practice-related score was 12.80 ± 3.34, with the majority of participants having inadequate practices. Conclusion COVID-19 knowledge, attitude, and preventive practices of the illiterate population in Pakistan are unsatisfactory. This study highlights the gaps in specific aspects of knowledge and practice that should be addressed through awareness campaigns targeting this specific population.

Copyright © 2021 Harsch, Jawid, Jawid, Saboga-Nunes, Sørensen, Sahrai and Bittlingmayer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms., Background: Health literacy is a determinant of health and assessed globally to inform the development of health interventions. However, little is known about health literacy in countries with one of the poorest health indicators worldwide, such as Afghanistan. Studies worldwide demonstrate that women play a key role in developing health literacy. Hence, this study's purpose is to explore health literacy of women in Afghanistan and the associated factors. Methods: From May to June 2017, we randomly recruited 7-10 women per day at the hospital in Ghazni, a representative province of Afghanistan. Two trained female interviewers interviewed 322 women (15-61 years old) orally in Dari or Pashto on a voluntary basis and assessed their health literacy using the HLS-EU-Q16, associated socio-demographics, and health behavior. Results: Health literacy of women (among educated and illiterates) is low even compared to other Asian countries. Health literacy is linked to age and education. We found mixed evidence of the relationship between health literacy and contextual factors, help-seeking, and health-related behavior. Conclusion: This study provides novel data on health literacy and astonishing insights into its association with health behavior of women in Afghanistan, thus contributing to health status. The study calls for recognition of health literacy as a public health challenge be addressed in Afghanistan and other low-income countries affected by crises.

Level of education is known to confound neuropsychological test performance. The INECO Frontal Screening (IFS) is an easy-to-use and brief measure of several domains of executive function, which has previously shown reliably clinical usefulness and superior psychometric performance when compared to other frontal screening instruments. However, previous studies with the IFS have been limited to participants with high levels of education, preventing its generalizability to populations with less than 12 years of formal education. This is crucial, as less than half of the Latin American population and a large percentage of immigrants in developed countries attain high school education. The aim of this study was to generate IFS normative data in a sample stratified by age and education levels. One hundred and sixty one healthy adults were assessed with the IFS as well as measures of global cognitive screening, namely, the Addenbrooke Cognitive Examination Revised and the Mini-Mental State Examination. Multiple lineal regression analysis showed significant effects for education and nonsignificant effects for age. A correction grid for IFS raw scores was developed and cut-off scores were calculated. The correction grid and cut-off scores may be useful in the interpretation of IFS scores in participants with low education. Fil: Sierra Sanjurjo, Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencias Cognitivas y Traslacional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina Fil: Saraniti, Antonella Belén. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina Fil: Gleichgerrcht, Ezequiel. Medical University Of South Carolina; Estados Unidos Fil: Roca, María. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencias Cognitivas y Traslacional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina Fil: Manes, Facundo Francisco. Macquarie University.; Australia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencias Cognitivas y Traslacional; Argentina Fil: Torralva, Teresa. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencias Cognitivas y Traslacional; Argentina. Macquarie University.; Australia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina

Aging can lead to functional and cognitive alterations, sometimes limiting older adults in their social development, especially illiterate groups of older adults who receive poor attention from healthcare systems. In this context, the present investigation proposes the cognitive training program &ldquo, MENTE SANA [HEALTHY MIND]&rdquo, to improve the cognitive functions of illiterate older adults in Arequipa (Peru). It is a type of quasi-experimental research with a pre-test/post-test design with a homogenous control group. The sample was made up of adults 60 years old and above and of female gender. The Montreal Cognitive Assessment (MoCA) test was used to detect the level of cognitive decline in illiterate older adults. The 50-sessions program was applied to all the older adults with mild cognitive impairment that were selected for the study, on a daily basis. It was found that the tested group improved their cognitive functions compared to the control group. These results help to propose adapted cognitive training programs for illiterate people.

Introduction. Traumatic brain injury (TBI) is affected by multiple factors. Patient’s education, manifesting symptoms and surgical management play a significant role on discharge outcome. The literature of same from developing country is limited. The present pilot study aims to describe patient characteristics, presenting symptom and management aspects of TBI patients from a tertiary hospital. Methods. The present study is a prospective study, where TBI patients were selected and data of injury was entered on standard proforma on electronic data base. The study was approved by institute ethical board. The data was analyzed using Stats Direct version 3.0.150 software. Results. Three hundred and thirty three patients were evaluated. Eighty percent of patients were from rural areas. About 75% of patients were illiterates and married. Patient employment was significant with discharge outcome. All the patients manifested with symptoms loss of consciousness (LOC) was higher (73%) followed by vomiting (44%). LOC and oral bleed was significant with outcome. Associated injuries was higher in extremities (22.5%) followed by chest (4.4%). About 15% of patients require intracranial surgery that was significant with discharge outcome. Conclusion. The present pilot study finding is similar to available literature data and adds knowledge to TBI data of a developing country like India.

Background Delirium is a common complication after cardiac surgery in older adult patients. However, risk factors and the influence of delirium on patient outcomes are not well established. We aimed to determine the incidence, predisposing and triggering factors of delirium following cardiac surgery. Methods One hundred seventy-three consecutive patients aged ≥60 years were studied. Patients’ characteristics and two cognitive function assessment tests were recorded preoperatively. Perioperative variables were blood transfusion, orotracheal intubation time (OIT), renal dysfunction, and hypoxemia. Delirium was assessed using the Confusion Assessment Method for the Intensive Care Unit. The composite outcome consisted of death, infection, and perioperative myocardial infarction until hospital discharge or 30 days after surgery, and for up to 18 months. Results One hundred six patients (61.27%) were men and the age was 69.5 ± 5.8 years. EuroSCORE II index was 4.06 ± 3.86. Hypertension was present in 75.14%, diabetes in 39.88%, and 30.06% were illiterate. Delirium occurred in 59 patients (34.1%). Education level (OR 0.81, 0.71–0.92), hypertension (OR 2.73, 1.16–6.40), and mitral valve disease (OR 2.93, 1.32–6.50) were independent predisposing factors for delirium, and atrial fibrillation after surgery (OR 2.49, 1.20–5.20) represented the potential triggering factor. Delirium (OR 2.35, 1.20–4.58) and OIT ≥ 900 min (OR 2.50; 1.30–4.80) were independently associated with the composite outcome. Conclusions In older adult patients submitted to cardiac surgery, delirium is a frequent complication that is associated with worst outcome. Independent risk factors for delirium included education level, hypertension, mitral valve disease, and atrial fibrillation after cardiac surgery.

Background: Mini-mental state examination (MMSE) scale measures cognition using specific elements that can be isolated, defined, and subsequently measured. This study was conducted with the aim to analyze the factorial structure of MMSE in a largely, illiterate, elderly population in India and to reduce the number of variables to a few meaningful and interpretable combinations. Methodology: Principal component analysis (PCA) was performed post-hoc on the data generated by a research project conducted to estimate the prevalence of dementia in four geographically defined habitations in Himachal Pradesh state of India. Results: Questions on orientation and registration account for high percentage of cumulative variance in comparison to other questions. Discussion: The PCA conducted on the data derived from a largely, illiterate population reveals that the most important components to consider for the estimation of cognitive impairment in illiterate Indian population are temporal orientation, spatial orientation, and immediate memory.

Introduction A considerable segment of the elderly population in Iran is illiterate, and it seems the existing neuropsychological screening tests are not very useful for detecting dementia in illiterate participants. The purpose of this study was to develop and validate a tool called Persian test of Elderly for Assessment of Cognition and Executive function (PEACE) for detecting dementia in both illiterate and literate participants. Methods First, in order to design some of the cognitive aspects of the PEACE assay, we considered other prevalent neuropsychological instruments, such as the General Practitioner assessment of Cognition (GPCOG), Functional Assessment Staging (FAST), Mini Mental State Examination (MMSE), and Wechsler Memory scale. The other domains of PEACE were designed according to our clinical proficiencies and the culture of the society. In the next step, the participants were classified into three distinct groups, i.e., the control group (n=33), the Mild Cognitive Impairment (MCI) group (n=30), and the Alzheimer's group (n=38). All of the participants in each group were divided according to their educational level, i.e., illiterate, semi-literate, and literate. Results We developed PEACE consisting of 14 items, each of which represents a specific cognitive function, with a maximum score of 91. The 14 items are Orientation, Praxis, Attention and Concentration, Attention and Calculation, Memory, Similarity, Abstract Thinking, General Information, Language, Judgment, Gnosis, Planning (Sequencing), Problem Solving, and Animal Naming. PEACE scores are highly correlated with those of the MMSE (r=0.78). The optimal cut-off point of PEACE chosen for diagnosis of Alzheimer's disease was 67.5 (sensitivity: 75.8%, specificity: 97.4%). The PEACE scores showed a significant difference between Participants with Alzheimer's disease and the control group (p=0.0000) and the MCI group (p=0.003). In addition, there was no significant difference between illiterate and literate participants in the Alzheimer's group. However, the PEACE scores differed significantly (p=0.0000) between illiterate and literate participants in the control group. Conclusion The PEACE addresses the limitations of existing tests and is appropriate for use in countries that have high rates of illiteracy. It is a valid screening mechanism for the detection of dementia in both illiterate and literate participants.

Pharmaceutical pictograms have the potential to play an important role in optimizing compliance in the illiterate patient population. Pictograms may improve warning comprehension for those with visual or literacy difficulties and can sometimes be recognized and recalled far better than words. The main purpose of this study is to determine whether these pictograms can be effectively understood by illiterate patients, who otherwise cannot read the instructions given on their prescription order. In this study, 10 pharmaceutical pictograms were evaluated in patients attending the outpatient department of the Shri Mahant Indresh Hospital, a multispecialty, referral hospital in Dehradun (Uttarakhand). Understanding of pictograms by patients before and after interpretation was noted and follow-up interpretation was also noted. Results of the study showed that prior to explanation, the majority of the patients were unable to interpret the pictograms correctly but after explanation of their meaning, interpretation by them showed a marked improvement, indicating the need of using pictograms along with verbal reinforcement. The study also highlighted poor patient follow-up, a major cause of patient non-compliance, often leading to a poor therapeutic outcome of the prescribed medication order. Such problems can be taken care of by an active participation by healthcare professionals.

Made available in DSpace on 2019-09-12T16:53:45Z (GMT). No. of bitstreams: 0 Previous issue date: 2009 Limb praxis can be influenced by age, gender, and education. The present Study investigated the influence of these variables on gesture production by healthy elderly Subjects. We evaluated 96 individuals divided into two age groups (60-74 and 75-88 years). Each group contained 48 men and 48 women and was subdivided into four groups according to education: illiterates and 1-3, 4-7, and 8 or more years of education. Individuals were requested to carry Out tasks oil verbal command and imitation. There were no differences between the performance of men and women, while older individuals performed worse than their younger counterparts. Regarding educational level, three major groups emerged: illiterates, individuals with 1-7 years of education, and those with 8 or more years of education. In conclusion, age and education significantly influenced the performance of individuals in limb praxis tests. (JINS, 2009, 157 618-622.) [Caramelli, Paulo] Univ Fed Minas Gerais, Fac Med, Dept Internal Med, Behav & Cognit Neurol Unit, BR-30130000 Belo Horizonte, MG, Brazil [Cavalcante, Karla Rodrigues] Universidade de Taubaté (Unitau), Dept Phys Therapy [Cavalcante, Karla Rodrigues; Caramelli, Paulo] Univ Sao Paulo, Sch Med, Dept Neurol, Sao Paulo, Brazil

Context: There is a widespread ignorance among the public about the role of anesthesiologists and their responsibilities inside or outside the operating room both in developed and developing countries. Aims: The present study was conducted to assess the knowledge of literate and illiterate patient about the role of anesthesiologists and their concerns regarding anesthesiology. Setting and Design: This is a prospective study conducted in a preoperative anesthetic clinic of a large tertiary care hospital. The study consisted of a standard preanesthetic interview and questionnaire. Materials and Methods : After obtaining permission from the Ethics committee, patients in the age group 18-75 years of either sex undergoing elective surgery were included.The patients were divided into two groups on the basis of their education: Group A: included patient who are illiterate; Group B: included patients who are literate, completed a questionnaire, which was later evaluated. Statistical Analysis Used: Unpaired t test and correlation r test were used. Results: There was limited knowledge among both literates and illiterates regarding the perioperative role of anesthesiologists. They wanted to be fully explained about the anesthesiology technique and were keen to meet their anesthesiologist both before and after the surgery. Conclusion: To eliminate the ignorance among general public regarding the role of anesthesiologists, efforts must be made to educate and generate awareness among the population.