Development and validation of Dementia Solat Score for detecting cognitive impairment among Muslim patients: A pilot study

Abstract

Background & Objective: Low education and simplicity of lifestyle of Malaysian older adults may mask the early signs of dementia and lead to late presentation with various complications and neglect. From clinical observation, decline in prayer performance in older Muslims might be a sign of cognitive impairment. This study aim to develop and validate an objective assessment tool for dementia based on Muslim routine prayer performance status.

Methods: This was a pilot study which involved Muslim participants aged 50 and above. They were divided into normal cognitive control group and cognitive impaired group. Clinical Dementia Rating (CDR) was done on all participants upon recruitment, and Dementia Solat Score (DSS) was done by another group of assessors which were blinded to CDR findings. All the statistical analyses was performed using R statistical software, Version 3.5.2.

Results: There were total of 36 participants, 16 from normal cognitive control group and 20 from cognitive impaired group. DSS score was significantly lower in cognitive normal control (median=0, IQR=0) compared to cognitive impaired group (median=4, IQR=9.0), Z=-4.54, p<0.001. Spearman’s rank-order correlation test between CDR and DSS revealed a positive correlation between the two assessment tools, r= 0.920, p<0.001. The cut-off point of 1 and above in DSS showed a sensitivity of 85.0%, specificity of 93.8%, positive predictive value of 94.4% and negative predictive value of 83.3%.

Conclusions: This pilot study showed that DSS has high sensitivity and specificity in detecting cognitive impairment among Muslim patients. A higher score in DSS may indicate more severe stage of disease.