Comparing MMSE and RUDAS in detecting cognitive impairment: A population-based study from Punjab, North India

Abstract

Background The Mini Mental State Examination (MMSE) and Rowland Universal Dementia Assessment Scale (RUDAS) are commonly used tools for screening cognitive impairment (CI) in epidemiological research globally. However, discrepancies have been noted in their ability to detect CI. Hence, present study was carried out to understand the test performance of MMSE and RUDAS among adults of a homogeneous group of rural Punjab, North India. Methods A total of 956 adults aged 18–75 years of both sexes, were recruited from the Jat Sikh community in rural Punjab. Sociodemographic (age, sex, marital status, employment status, annual income, family size) and lifestyle variables (smoking behavior, alcohol intake, and diet pattern) were collected using pretested and modified interview schedules. CI screening was performed using MMSE and RUDAS tools. Statistical analysis was conducted using SPSS software version 22. Results The overall prevalence of CI was found to be 40.3% and 27.8% using MMSE & RUDAS respectively. MMSE and RUDAS demonstrated a moderate correlation (Spearman correlation coefficient = 0.43) and a moderate agreement (Kappa value = 0.42). The highest concordance (79.1%) between the two tools in detecting CI was observed among elderly participants ( > = 60 years). Furthermore, in sociodemographic and lifestyle categories, both tools showed relatively higher concordance, with no discrepancies among the elderly group. Conclusions MMSE and RUDAS have shown a moderate correlation and agreement among the studied group. However, relatively higher concordance was observed among elderly individuals. Hence, both the screening tools should primarily be used for the elderly group. Whereas, modifications maybe needed to administer them on the younger group.