Prevalence of cognitive impairment among older adult Palestinians in community and nursing home settings.

Abstract

Cognitive impairment in older adults represents a critical global public health challenge. This study aimed to describe the prevalence of cognitive impairment and the clinical characteristics of Palestinian older adults living in nursing homes and in the community. A cross-sectional study was conducted from May to October 2024 among 441 Palestinians aged 55 years and older, recruited from 10 charitable nursing homes and primary healthcare centers across the West Bank. Cognitive function was evaluated using the validated Arabic version of the Mini-Mental State Examination A-MMSE (GTD-USJ). Comprehensive sociodemographic, clinical, and lifestyle information was collected to describe the two groups. Of the 441 participants, 305 were recruited from primary healthcare centers and 136 from nursing homes. The median age of residents in nursing homes was 73.0 years. The population had a high prevalence of illiteracy (41.9%) and was predominantly female (66.9%). Clinically, 58% were obese or overweight. The most common illnesses were hypertension (47.8%) and diabetes (30.9%). On the other hand, the median age of primary health care attendees was 65.0 years. The population was 45.2% male, 27.9% smokers, 16.1% illiterate, and 27.5% had completed university. The most common conditions were dyslipidemia (59%), diabetes (50.2%), and hypertension (67.9%). In the nursing home cohort, significant associations with cognitive impairment were identified for gender (p = 0.030), smoking status (p < 0.001), educational attainment (p < 0.001), and monolingualism (p < 0.001). Among primary healthcare attendees, cognitive impairment was significantly correlated with gender (p < 0.001), smoking status (p < 0.001), educational attainment (p < 0.001), and monolingualism (p = 0.003). This descriptive study documents the first baseline prevalence data for both care settings and nursing home residents in Palestine and underscores the need for geriatric care standards tailored to the local population. The data support investment in longitudinal cohort research to characterize the natural history of cognitive decline in this population, as well as enhanced management of modifiable risk factors and evidence-based cognitive stimulation programs within nursing facilities.