Can Rowland Universal Dementia Assessment Scale (RUDAS) Replace Mini-Mental State Examination (MMSE) for Dementia Screening in a Thai Geriatric Outpatient Setting?

Abstract

Mini-mental-State Examination (MMSE) is a widely used tool for dementia screening. However, several limitations are found and the Rowland Universal Dementia Assessment Scale (RUDAS) appears to be an alternative test. The objective in this study was to compare the performance of MMSE-Thai 2002 and RUDAS-Thai for dementia screening, and to determine their performances and identify their optimal cut-off points. The participants were older patients from a Geriatric and Neurology Outpatient Clinic, Srinagarind Hospital, Khon Kaen University. The RUDAS-Thai and the MMSE-Thai 2002 were administered to each participant. Subsequently, a specialist physician assessed each participant for dementia. Results showed the area under receiver operating characteristic curve for both RUDAS-Thai (81.0%; 95%CI, 74.8-87.2) and MMSE-Thai 2002 (81.2%; 95%CI, 74.9-87.4) were equal. A score of 24 or lower provided an optimal cut-off point. Our finding supports that the RUDAS-Thai can be an effective alternative test for dementia screening. For both test scores, a score of 24 or lower is an optimal cut-off point to provide an indication of developing dementia.

Cognitive assessments in multicultural populations using the Rowland Universal Dementia Assessment Scale: a systematic review and meta-analysis

“…Four studies did not report clearly on the method of participant selection. 20,21,23,25 Of the 8 studies that were used to assess the psychometric properties of the RUDAS, one was a casecontrol study 21 and one did not prespecify the cut-off point to determine a positive test on the RUDAS. 24 Two studies also excluded participants with mild cognitive impairment in their analyses.…”

“…24 Two studies also excluded participants with mild cognitive impairment in their analyses. 22,25 In the 3 studies that only compared the RUDAS with the MMSE, 19,20,28 assessors were aware of the dementia status of participants. The threshold or cut-off score of either test was also not prespecified in these 3 studies.…”

Validation of the Rowland Universal Dementia Assessment Scale for Multicultural Screening in Danish Memory Clinics

“…It has been translated into several languages, including Danish [6], and is seen as being culturally and educationally fair [5,7]. The RUDAS has been validated in multicultural populations in Australia [5,8,9,10], India [7] and Thailand [11]. In addition, studies have examined the clinical utility of the RUDAS in a predominantly Chinese population in Australia [12] and the influence of demographic and acculturation variables on RUDAS performance in a Turkish population in Denmark [6].…”

Comparison of Three Cognitive Screening Tools in Older Urban and Regional Aboriginal Australians

“…The RUDAS is also said to be less influenced by sociodemographic factors such as education [14,16,19,20], but this might not be the case in all populations [17,21]. In direct comparison with the MMSE, the RUDAS has generally been found to have similar accuracy for dementia screening [15,16,17,18,19,20]. …”

“…The RUDAS [7] is a cognitive screening tool that was specifically designed to minimize the impact of cultural differences on test performance. It has been validated in culturally diverse groups, both in Australia [14,15,16], where it was initially developed, and internationally [17,18,19]. RUDAS performance is not associated with cultural or language background in multicultural settings [14,15,19].…”