Introduction: The age of the population in Saudi Arabia is shifting toward elderly, which can lead to an increased risk of mild cognitive impairment (MCI) and dementia. Objective: The aim of this study is to determine the prevalence of cognitive impairment (MCI and dementia) among elderly patients in a community-based setting in Riyadh, Saudi Arabia. Methods: In this cross-sectional study, we included patients aged 60 years and above who were seen in the Family Medicine Clinics affiliated with King Faisal Specialist Hospital and Research Centre. Patients with delirium, active depression, and patients with a history of severe head trauma in the past 3 months were excluded. Patients were interviewed during their regular visit by a trained physician to collect demographic data and to administer the validated Arabic version of the Montreal Cognitive Assessment (MoCA) test. Results: One hundred seventy-one Saudi patients were recruited based on a calculated sample size for the aim of this study. The mean age of included sample was 67 ± 6 years. The prevalence of cognitive impairment was 45%. The prevalence of MCI was 38.6% and the prevalence of dementia was 6.4%. Age, low level of education, hypertension, and cardiovascular disease were risk factors for cognitive impairment. Conclusion: Prevalence of MCI and dementia in Saudi Arabia using MoCA were in the upper range compared to developed and developing countries. The high rate of risk factors for cognitive impairment in Saudi Arabia is contributing to this finding.

Introduction: The prevalence of sleepy driving and sleep-related accidents (SRA) varies widely, and no data exist regarding the prevalence of sleepy driving in Saudi Arabia. Therefore, this study was designed to determine the prevalence and predictors of sleepy driving, near-misses, and SRA among drivers in Saudi Arabia. Materials And Methods: A questionnaire was developed to assess sleep and driving in detail based on previously published data regarding sleepy driving. The questionnaire included 50 questions addressing socio-demographics, the Epworth Sleepiness Scale (ESS), driving items, and the Berlin Questionnaire. In total, 1,219 male drivers in public places were interviewed face-to-face. Results: The included drivers had a mean age of 32.4 ± 11.7 years and displayed a mean ESS score of 7.2 ± 3.8. Among these drivers, 33.1% reported at least one near-miss accident caused by sleepiness. Among those who had actual accidents, 11.6% were attributed to sleepiness. In the past six months, drivers reported the following: 25.2% reported falling asleep at least once during, driving and 20.8% had to stop driving at least once because of severe sleepiness. Young age, feeling very sleepy during driving, and having at least one near-miss accident caused by sleepiness in the past six months were the only predictors of accidents. Conclusion: Sleepy driving is prevalent among male drivers in Saudi Arabia. Near-miss accidents caused by sleepiness are an important risk factor for car accidents and should be considered as a strong warning signal of future accidents.

Osteoporosis is a disease of bone density. It makes bones fragile and easy to break. Fragility fractures can cause significant morbidity, mortality, poor quality of life, and financial stress on medical care. Osteoporosis is overlooked and undertreated. Saudi Arabia issued a national plan promoting the early diagnosis and management of osteoporosis. Few and old studies are available in Saudi Arabia estimating the prevalence of osteoporosis in the Saudi older adult population. The aim of this study is to measure the prevalence of osteoporosis and osteopenia among older adult patients. This retrospective cross-sectional study is based on data gathered from patients ≥60 years of age. Data were collected from January 1, 2016, to December 31, 2021, for patients who were attending family medicine clinics at King Faisal Specialist Hospital & Research Centre in Riyadh, Saudi Arabia, who were screened using dual-energy X-ray absorptiometry (DEXA). Patients who have secondary causes of osteoporosis were excluded. A total of 1,302 patients were studied during the course of data collection. The mean age was 68.26. Out of the studied subjects, 75% were female and 25% were males. The prevalence of osteoporosis was 8.2% and 11.8% in femoral and lumbar bone mineral density (BMD) results, respectively. The prevalence of osteopenia based on femoral and lumbar BMD results was 50.2% and 41.2%, respectively. Osteoporosis and osteopenia are prevalent in the Saudi older adult population. Multiple clinical characteristics have been associated with low bone density disease. Thus, it is important to reinforce primary care physicians’ efforts for early screening and treatment of the Saudi older adult population based on their clinical and demographic risk factors.

Immune thrombocytopenia (ITP) is an autoimmune disorder marked by low platelet counts that puts patients at risk for spontaneous bleeding. A rare trigger for ITP is iron repletion, which has only been reported in a few cases. In this article, we present a unique case of a 54-year-old male with a history of recurrent ITP who experienced rapid thrombocytopenia following iron repletion with ferrous gluconate. Discontinuation of ferrous medications resulted in platelet counts returning to the normal baseline. Following more than 30 years of the patient’s clinical timeline, this case demonstrates the chronic nature of ITP and the complexity of its causes. Further studies are needed to determine the prevalence of iron repletion-induced thrombocytopenia and its underlying mechanisms.

Summary: Osteoporosis is a growing health burden requiring early risk assessment. In Saudi adults ≥ 60 years, FRAX scores with and without BMD showed minimal reclassification, with most shifts toward higher risk in younger groups. FRAX without BMD offers reliable stratification, supporting its use as a first-line screening tool. Methods: A retrospective cross-sectional study included patients aged ≥ 60 years attending family medicine clinics at King Faisal Specialist Hospital & Research Centre, Riyadh, undergoing DXA screening between January 1, 2016, and December 31, 2022. Baseline variables were age, sex, and BMI. FRAX variables assessed were family history of hip fracture (HF), prior fracture, smoking, glucocorticoid use, rheumatoid arthritis, and alcohol intake. Fracture risk was categorized using fixed and age-specific thresholds; differences in FRAX scores and reclassification patterns were evaluated. Results: Among 1,429 patients (mean age 68.07 ± 6.62 years), FRAX scores for major osteoporotic fracture (MOF) and HF) differed significantly with and without BMD. Subgroup analysis revealed no significant differences within specific age ranges (70–75 years for MOF and 60–75 years for HF) or among men across all age groups. Reclassification occurred in a small subset of patients, predominantly shifting toward higher-risk categories, particularly in younger age groups. Conclusion: FRAX without BMD provides robust risk stratification, with minimal impact on reclassification across age categories. These results highlight its utility as a primary screening strategy, whereas BMD assessment may be reserved for cases requiring further refinement. Purpose: Osteoporosis is a skeletal disorder defined by reduced bone mineral density (BMD), commonly assessed by dual-energy X-ray absorptiometry (DXA). The Fracture Risk Assessment Tool (FRAX) estimates 10-year fracture risk. Saudi Arabia was recently included in FRAX, enabling population-specific risk estimation. Notably, FRAX can be applied with or without BMD, but limited Saudi data exist comparing both methods.

BACKGROUND: T-score measurement via dual-energy X-ray absorptiometry (DXA) is the gold standard for assessing and classifying the bone mineral density status of patients as normal, osteopenic, or osteoporotic according to the World Health Organization criteria. However, the diagnostic accuracy may be affected by the skeletal site selected for DXA. OBJECTIVES: Estimate the prevalence of femoral and lumbar BMD discordance in a community-based setting in Riyadh, Saudi Arabia. DESIGN: Cross-sectional SETTING: Polyclinics at a tertiary care center PATIENTS AND METHODS: This study included all patients aged >= 60 years who visited the Department of Family Medicine and underwent DXA screening between 2016 and 2022. MAIN OUTCOME MEASURES: Discordance was defined as a difference in BMD status between two skeletal sites. Minor discordance occurs when adjacent sites have different diagnoses; i.e., one site exhibits osteoporosis and the other exhibits osteopenia. In contrast, major discordance occurs when one site exhibits osteoporosis and the other exhibits normal BMD. SAMPLE SIZE: 1429 older adults RESULTS: The study patients had a median age of 66 years (60-99, minimum-maximum). The prevalence of discordance was 41.6%, with major discordance present in 2.2% of patients and minor discordance in 39.4%. The distribution of discordance did not differ significantly among the sociodemographic factors. CONCLUSION: Discordance is prevalent among the Saudi geriatric population. During the analysis of DXA results, physicians should account for discordance when diagnosing and ruling out osteoporosis in high-risk patients. LIMITATIONS: All factors influencing discordance were not explored thoroughly; this study mainly focused on older adults. Furthermore, diverse age groups need to be investigated for a more comprehensive of the factors.