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Cognitive reserve is the adaptability of cognitive processes in the face of brain aging and pathology. This study aimed to validate the Arabic version of the Cognitive Reserve Index Questionnaire (CRIq) in a healthy Lebanese sample. CRIq assesses cognitive reserve through three domains: education, working activity, and leisure time. Statistical measures, including descriptive and regression analysis along with structural equation modeling, were utilized to investigate the convergent and discriminant validity of the CRIq, incorporating fluid intelligence (Gf) and measures of cognitive function, long-term memory encoding and retrieval (Glr), and processing speed (Gs). Results from 174 participants revealed that the activities assessed by the CRIq-Arabic were comparable to the original CRIq study, with slight cultural differences. The internal consistency of the CRIq-Arabic was good (Cronbach's α = 0.88), indicating reliability. Convergent validity was confirmed, with moderate to high loadings on the cognitive reserve latent construct. Discriminant validity was supported as correlations between cognitive reserve variables and non-target constructs (Gf, Glr, and Gs) were less than 1. The findings provide an initial psychometric validation of the CRIq-Arabic. Further research of clinical samples is needed to enhance its utility in neuropsychological practice. [ABSTRACT FROM AUTHOR]

Tests of verbal memory (list learning) are particularly useful for clinicians and researchers globally, yet there are no psychometrically robust tests that are built indigenously for Arabic-speaking populations, which comprise more than 370 million. To develop a verbal memory Arabic test using a systematic procedure of item selection and then provide evidence of validity and reliability in an Arabic-speaking sample in Lebanon. In study 1, we conducted a word prototypicality study (n = 77), and identified 932 words across 7 semantic categories. Following quantitative analyzes and qualitative judgments by an expert panel, we selected a sufficient number of words and categories, and constructed and piloted the items, instructions, and protocol for the Verbal Memory Arabic Test (VMAT). In study 2, we administered the VMAT on a community sample (n = 199; screened for depression and cognitive impairment) and patients with Multiple Sclerosis (n = 16). Scores decreased with age as expected, they discriminated well between healthy and clinical populations (matched on age, sex, and years of education), and showed acceptable consistency within items and across time. Conclusions: The VMAT is the first Arabic test developed indigenously. It can be used in clinical and research settings with Arabic-speaking populations to assess verbal learning. [ABSTRACT FROM AUTHOR]

• Multiple Sclerosis (MS) is associated with processing speed impairment. • MS patients with deficient 25(OH)D vs. sufficient have slower processing speed • 25(OH)D changes in MS could predict changes in processing speed. • Clinical monitoring and supplementation of 25(OH)D in MS is reinforced. Multiple Sclerosis (MS) is often associated with low serum 25(OH)D levels, as well as cognitive dysfunctions. The relationship between 25(OH)D and the most commonly affected cognitive domain in MS; processing speed, is poorly explored. The purpose of this study is to: (1) assess the effect of serum 25(OH)D change on processing speed in MS, and (2) explore the relationship between serum 25(OH)D and brain volume changes in MS. A retrospective chart review was conducted, data from 299 patients were extracted (baseline), of whom 163 had follow-up measurements (after at least a 9-month interval). The Symbol Digits Modalities Test (SDMT) was used as a measure of processing speed. MRI data was available from 78 individuals at baseline, and 70 at follow-up. SDMT scores and brain volumes (Cerebellum (total, grey, and white), intracranial, Grey Matter (GM), and White Matter (WM)) were compared based on 25(OH)D levels and their changes towards follow-up. Results indicated that patients with deficient 25(OH)D levels had lower SDMT scores when compared to those with sufficient levels, and SDMT scores improved as a function of 25(OH)D. For MRI measures, only patients with sufficient 25(OH)D levels during both assessment periods had significant changes in intracranial and total cerebellum volumes. We conclude that 25(OH)D levels seem to have an effect on processing speed in MS, thus the importance of clinical monitoring and supplementation in this regard is reinforced. [ABSTRACT FROM AUTHOR]

Objective: Multiple sclerosis (MS) is often associated with cognitive deficits. Accurate evaluation of the MS patients' cognitive performance is essential for diagnosis and treatment recommendation. The Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS), widely used cognitive testing battery, examines processing speed, verbal and visuospatial learning, and memory. Our study aims to examine the psychometric properties of an Arabic version of the BICAMS and to provide normative values in a Lebanese sample. Method: The BICAMS, comprised of the Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT-R), and a newly developed verbal learning/memory test, the Verbal Memory Arabic Test (VMAT), were administered on healthy subjects and MS patients. The sample consisted of 180 healthy individuals, of whom 63 were retested after 2–3 weeks. Forty-three MS patients matched with 43 healthy subjects based on age, sex, and years of education were assessed. A sample of 10 MS patients was also examined on two occasions. Test–retest reliability and criterion-related validity were examined, and regression-based norms were derived. Results: The test–retest correlations showed good evidence of reliability with coefficients ranging between 0.64 and 0.73 in the healthy sample, and between 0.43 and 0.92 in the MS sample. The BICAMS was able to discriminate between MS patients and matched healthy participants on the SDMT and BVMT-R. Normative data were comparable to other studies. Conclusions: This new Arabic version of the BICAMS shows initial good psychometric properties. While good evidence of VMAT's reliability was shown in the healthy participants, less test–retest reliability in this tool was seen in the MS group, and partial criterion-related validity was evident. This renders further examination of the VMAT. We provide regression-based norms for a Lebanese sample and encourage the use of this battery in both research and clinical settings. [ABSTRACT FROM AUTHOR]

The effect of eating behavior and personality on glycemic outcomes in type 2 diabetes (T2DM) has received little attention. Diabetes fatalism has furthermore been associated with uncontrolled glycemia. The aim of the present study is to explore the interrelationship of these constructs, which might uncover new insights for diabetes management. A total of 333 Lebanese patients (Age: 59 ± 13 years, 50.2% M) with T2DM were recruited. Eating behaviours (Dutch Eating Behaviour Questionnaire), personality traits (NEO Five-Factor Inventory-3), and diabetes related fatalistic attitudes (Diabetes Fatalism Scale) were assessed. Regression analyses showed that neuroticism, restrained eating, and external eating predicted A1C. Total diabetes fatalism and its 'despair' subscale also predicted HbA1C. Multiple regression analysis showed that neuroticism, restrained eating, and fatalism subscale 'despair' predicted HbA1C levels and explained 5.4% of the variance (F(3,302) = 5.77, p =.001). A moderated moderation was run and revealed that the effect of conscientiousness on restrained eating was moderated by powerlessness (fatalism subscale) and neuroticism. At low neuroticism levels and with any powerlessness levels, conscientiousness did not exert a significant effect on restrained eating. However, at high levels of neuroticism with low or moderate levels of powerlessness, conscientiousness exerted significant effect on restrained eating (low powerlessness: B =.07, t = 4.39, p <.001; medium powerlessness: B =.04, t = 3.24, p <.01). On the other hand, when powerlessness was high, conscientiousness did not exert a significant effect on restrained eating. In summary, the impact of conscientiousness on restrained eating, which in turn predicts HbA1C levels, is moderated by the belief of powerlessness and neuroticism in T2DM. These factors should be taken into account in the clinical practice. Further exploring similar constructs in T2DM to improve the quality of health care is warranted. Disclosure: N. Farran: None. O.A. Sukkarieh-Haraty: None. D. Al Bakhour: None. M. Bassil: None. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to provide normative data for four trials of the Rey figure Test - a complex design used to assess visuoconstructional abilities, aspects of visual memory, and aspects of executive functioning. Despite its frequent clinical and research use in the Arab region, published studies regarding the measures' adaptation or normative data remain absent. Method: We administered the Rey figure on a convenience sample of Lebanese (n = 254) aged 30 years to 99. Results: We examined the impact of relevant demographics, and found that age, gender, and years of education impacted scores, and norms were derived based on these variables. Such normative data for the Rey figure enhance its practicality and psychometric adequacy for use in research and clinical settings in Lebanon. [ABSTRACT FROM AUTHOR]

Objective: Diabetes self-management education (DSME) is an essential component of lifestyle management needed for diabetes care. This pilot-study tested the effect of culturally-tailored education targeting diabetes selfcare on glycemia and cardiovascular risk factors of Lebanese with type 2 diabetes mellitus (T2DM) (n = 27; Age: 61 ± 10 yrs, 59% males, HbA1c: 8.98 ± 1.38%). Results: Diabetes self-care (Diet, Self-Monitoring Blood Glucose and foot care) improved after 6 months, which was reflected in a significant drop in glycemic levels (HbA1c:-0.5%; FPG: − 38 mg/dl), and cholesterol/HDL ratio (4.45 ± 1.39 vs. 4.06 ± 1.29). Waist circumference decreased at 6 months compared to 3 months (p < 0.05). This is the first effective culturally-tailored intervention that improved self-care, glycemic control, body adiposity and lipid profile of Lebanese with T2DM. Larger scale implementation with representative sample is warranted. [ABSTRACT FROM AUTHOR]

Background: International T2DM Federation (IDF) estimates T2DM prevalence in Lebanese adults around 14%. Identifying people at risk of developing type 2 T2DM mellitus (T2DM) as to prevent rising prevalence and development of T2DM related complications is crucial. Aim: to identify people at high risk for developing T2DM. Methods: A convenience sample (N=198) of healthy Lebanese adults, 40 years of age and above, were recruited through snowballing from all over Lebanon. Food Frequency Questionnaire (FFQ), Short Test of Functional Health Literacy in Adults (STOFHLA), World Health Organization Quality of Life-BREF (WHOQoL-BREF), and ARABRISK were administered. Results: Majority of the participants were 40 to 54 years (74.25%), females (57.58%), married (51.02%), employed (59.90%) and reported having "enough to make ends meet" (64.29%). Significant association resulted between ARABRISK scale score and WHOQoL-BREF scale (β= -1.642, p= 0.001) as well as two of its subscales, physical (β= -2.21, p < 0.001) and psychological (β= -1.17, p= 0.003). Significant association was noted between ARABRISK scale score and demographic characteristics; mainly marital status, particularly being "married" (β= 15.47, p < 0.001) and "widowed/divorced" (β= 25.72, p < 0.001), and employment statuses particularly "not enough to make ends meet" (β= 8.64, p=.021).Significant association resulted between ARABRISK scale score and at whole grain consumption (β= -4.97, p = 0.035) and red meat (β= 13.02, p = 0.003). Marital status, red meat consumption, whole grains consumption, and physical health subscale were significantly associated with ARABRISK in the fully adjusted multiple linear regression model. The combination of the latter variables accounted for 36.83% of the variance of ARABRISK score. Conclusion: Findings will help health care practitioners to understand the determinants of T2DM risk, which will set the stage for effective preventive measures in reducing the risk and incidence of T2DM. Disclosure: O.A. Sukkarieh-Haraty: None. J. Abi Kharma: None. N. Farran: None. M. Bassil: None. Funding: Lebanese American University [ABSTRACT FROM AUTHOR]

Optimal diabetes management requires daily activities of self-care. Thus, understanding the sociodemographic determinants of diabetes self-care is crucial to improve diabetes control. The aim of this study is to compare diabetes self-care activities and their determinants in 2 populations of Arabs with type 2 diabetes (T2DM) living in their country of origin (Lebanon) or in the United States (U.S.). A total of 334 patients (59 ± 13 years; 52.1% M) living in Lebanon and 181 patients (62 ± 12 years; 52.5% M) living in the U.S. were recruited. Diabetes self-care activities were assessed using Summary of Diabetes Self-Care Activities Assessment (SDSCA); dimensions of diabetes distress were measured with the Diabetes Distress Scale (T1-DDS). Half of the population in Lebanon were employed, 61.6% had health insurance and 42.3% were smokers; while among those living in the U.S., 23.7% were employed, 96.1% had health insurance and 26.5% were smokers. There were no significant group differences for gender, marital status and education. Compared to those in Lebanon, patients living in the U.S. had significantly higher mean scores on various SDSCA subscales, including general diet (t = 5.24, p < 0.001), exercise (t = 3.31, p = 0.001), blood glucose testing (t = 4.41, p < 0.001), and foot care (t = 8.84, p < 0.001) indicating better diabetes self-care. Multiple regression analyses showed that total SDSCA scores correlated significantly with age (β= 0.06, p = 0.015) and education (β= 3.02, p=0.006) in patients living in Lebanon; whereas predictors of total SDSCA scores among participants living in the U.S. were education (β= 8.46, p = 0.005) and management distress subscale of T1-DDS (β= - 2.92, p < 0.001). In conclusion, Arab patients with T2DM living in the U.S. showed better diabetes self-care activities compared to those living in their country of origin. Predictors of self-care varied between the 2 populations. Further exploring other determinants is warranted. Disclosure: O.A. Sukkarieh-Haraty: None. L. Jaber: None. J. Abi Kharma: None. N. Farran: None. M. Bassil: None. [ABSTRACT FROM AUTHOR]