One Size Does Not Fit All: Comparative Diagnostic Accuracy of the Rowland Universal Dementia Assessment Scale and the Mini Mental State Examination in a Memory Clinic Population with Very Low Education

Goudsmit, Miriam; Campen, Jos van; Schilt, Thelma; Hinnen, Chris; Franzen, Sanne; Schmand, Ben

doi:10.1159/000490174

Cited by 42 publications

(40 citation statements)

References 54 publications

(73 reference statements)

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“…Additionally, three studies (Chen et al, 2015;Custodio et al, 2019; Matias-Guiu et al, 2017) did not report clearly on methods for patient selection, three (Cheung et al, 2015;Matias-Guiu et al, 2017;Nielsen et al, 2019c) on the interpretation of the RUDAS, four (Cheung et al, 2015;Nielsen et al, 2019c;Ramos-Ríosa et al, 2009;Shaaban et al, 2013) on the interpretation of the reference standard, and five (Cheung et al, 2015;Mateos-Alvarez et al, 2017;Matias-Guiu et al, 2017;Silpakit et al, 2018) on the flow and timing of the study. Applicability concerns were identified in three studies and were related to uncertain application of the RUDAS (Cheung et al, 2015;Custodio et al, 2019) or the reference standard (Goudsmit et al, 2018).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Translation and cultural adaption of the RUDAS Thirteen studies reported on procedures for translation and cultural adaption of the original Australian version of the RUDAS. In 10 studies (Ayan et al, 2019;Chaaya et al, 2016;Chen et al, 2015;de Araujo et al, 2018;Goudsmit et al, 2018;Iype et al, 2006;Limpawattana et al, 2012a;Nielsen et al, 2013;2019c;Shaaban et al, 2013), the RUDAS was translated from English into the target language (including Brazilian Portuguese, Chinese, classical Arabic, Danish, Dutch, French, German, Greek, Malay, Malayalam, Norwegian, Swedish, Thai, and Turkish) using translation-back-translation procedures but without making any cultural adaptation. Three studies reported cultural adaption of the RUDAS.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Eleven studies (Basic et al, 2009b;Chaaya et al, 2016;Cheung et al, 2015;Custodio et al, 2019;Goudsmit et al, 2018;Limpawattana et al, 2012a;Mateos-Alvarez et al, 2017;Nielsen et al, 2013;2019c;Rowland et al, 2006;Storey et al, 2004) used multivariable regression analysis to investigate the effects of demographic variables on the ability of the RUDAS to predict dementia. All of these studies investigated the effect of years of age: Australian (Storey et al, 2004), cross-European (Nielsen et al, 2019c), Danish (Nielsen et al, 2013), and Spanish (Mateos-Alvarez et al, 2017) studies found a significant effect, while the other studies did not.…”

Section: Influence Of Demographic Variablesmentioning

confidence: 99%

“…Three Australian (Basic et al, 2009b;Rowland et al, 2006;Storey et al, 2004), a cross-European (Nielsen et al, 2019c), and a Danish (Nielsen et al, 2013) study reported no significant effect of cultural and language factors (CALD status, preferred language other than English, or immigrant background). Six studies (Chaaya et al, 2016;de Araujo et al, 2018;Goudsmit et al, 2018;Limpawattana et al, 2012a;Mateos-Alvarez et al, 2017;Matias-Guiu et al, 2017) specifically investigated the effect of education by comparing diagnostic performances in groups with limited or no formal education and groups with more years of formal education. Two Spanish studies (Mateos-Alvarez et al, 2017;…”

Section: Influence Of Demographic Variablesmentioning

confidence: 99%

“…A Brazilian study (de Araujo et al, 2018) compared groups with ≤ 4 years of education and >7 years of education and found a higher AUC value in the higher educated group even when the cutoff value was lowered by one point in the lower educated group. A Dutch study (Goudsmit et al, 2018) in a loweducated immigrant sample found that the mean RUDAS score was 1.5 points lower in patients who were illiterate compared to those who were literate, and a cross-European study (Nielsen et al, 2019c) calculated normative data stratified by five educational groups (0 years, 1-6 years, 7-10 years, 11-13 years, and ≥ 14 years) based on a multicultural sample (n = 341) and recommends educational correction of RUDAS scores by adding two points to the raw score in people with 0 years of education and one point in people with 1-6 years of education. Applying this education adjustment resulted in a small but significant improvement in diagnostic accuracy.…”

Section: Influence Of Demographic Variablesmentioning

confidence: 99%

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Cross-cultural dementia screening using the Rowland Universal Dementia Assessment Scale: a systematic review and meta-analysis

Nielsen

Jørgensen

2020

Int. Psychogeriatr.

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Objectives: To quantitatively synthesize data on the accuracy of the Rowland Universal Dementia Assessment Scale (RUDAS) in different sociocultural settings and compare its performance to other brief screening instruments for the detection of dementia. Design: Systematic review and meta-analysis. Literature searches were performed in PubMed, EMBASE, and CINAHL from January 1, 2004 until September 1, 2019. Setting: Community, outpatient clinic, and hospital settings in high-, and low- and middle-income countries. Participants: Twenty-six studies reporting diagnostic accuracy of the RUDAS were included with almost 4000 participants, including approximately 1700 patients with dementia. Measurements: Procedures for translation and cultural adaption of the RUDAS, and influence of demographic variables on diagnostic accuracy, were compared across studies. Bivariate random-effects models were used to pool sensitivity and specificity results, and diagnostic odds-ratios and the area under the hierarchical summary receiver operator characteristic curve were used to present the overall performance. Results: The pooled sensitivity and specificity for the detection of dementia were .82 (95% CI, .78–.86) and .83 (95% CI, .78–.87), respectively, with an area under the curve of .89. Subgroup analyses revealed that the RUDAS had comparable diagnostic performances across high-, and low- and middle-income settings (z = .63, P = .53) and in samples with a lower and higher proportion of participants with no formal education (z = −.15, P = .88). In 11 studies making direct comparison, the diagnostic performance of the RUDAS was comparable to that of the Mini-Mental State Examination (z = −.82, P = .41), with areas under the curve of .88 and .84, respectively. Conclusions: The RUDAS has good diagnostic performance for detecting dementia in different sociocultural settings. Compared to other brief screening instruments, advantages of the RUDAS include its limited bias in people with limited or no formal education and a minimal need for cultural or language adaptation.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Influence Of Demographic Variablesmentioning

confidence: 99%

Section: Influence Of Demographic Variablesmentioning

confidence: 99%

Section: Influence Of Demographic Variablesmentioning

confidence: 99%

See 3 more Smart Citations

Cross-cultural dementia screening using the Rowland Universal Dementia Assessment Scale: a systematic review and meta-analysis

Nielsen

Jørgensen

2020

Int. Psychogeriatr.

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Neuropsychological assessment in the multicultural memory clinic: development and feasibility of the TULIPA battery

Franzen

Berg

Bossenbroek

et al. 2022

Alzheimer's & Dementia

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Objective: Neuropsychological assessment of culturally diverse populations is hindered by barriers in language, culture, education, and a lack of suitable tests. Furthermore, individuals from diverse backgrounds are often unfamiliar with being cognitively tested. The aim of this study was to develop a new neuropsychological test battery and study its feasibility in multicultural memory clinics. Method: Composition of the TULIPA battery (Towards a Universal Language: Intervention and Psychodiagnostic Assessment) entailed a literature review and consultation with experts and individuals from diverse backgrounds. Feasibility was investigated by examining administration and completion rates and the frequency of factors complicating neuropsychological assessment in 345 patients from 37 countries visiting four multicultural memory clinics in the Netherlands. Results: The test battery included existing tests such as the Cross-Cultural Dementia screening (CCD), Rowland Universal Dementia Assessment Scale (RUDAS), tests from the European Cross-Cultural Neuropsychological Test Battery, and newly developed tests. Completion rates for the test battery were generally high (82%-100%), except for CCD Dots subtest B (58%). Although tests of the "core" TULIPA battery were administered often (median: 6 of 7, IQR: 5-7), supplementary tests were administered less frequently (median: 1 of 9; IQR: 0-3). The number of administered tests correlated with disease severity (RUDAS, ρ=.33, adjusted p < .001), but not with other patient characteristics. Complicating factors were observed frequently, e.g. suboptimal effort (29%-50%), fatigue (29%), depression (37%-57%).

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Conversion between the Rowland Universal Dementia Assessment Scale and Mini‐Mental State Examination test scores in majority and minority populations

Delgado‐Álvarez,

Valles‐Salgado,

Delgado‐Alonso

et al. 2024

Brain and Behavior

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IntroductionDespite the Rowland Universal Dementia Assessment Scale (RUDAS) having significant advantages as a cognitive screening tool, particularly for minority populations, the Mini‐Mental State Examination (MMSE) test is the most widely used test for cognitive screening in Alzheimer's disease (AD). This study aimed to develop a conversion table to predict MMSE scores from observed RUDAS scores, allowing an easy‐to‐use method to compare both screening tests.MethodsThe equipercentile equating method was used to develop the conversion table using a training sample consisting of cognitively intact participants and individuals with early‐stage AD. The resulting conversion table was validated in two samples, comprising participants from majority and minority populations assessed in Spanish.ResultsThe conversion table demonstrated excellent reliability with intraclass correlation coefficients of.92 in both validation samples.ConclusionThis study provides a conversion table between RUDAS and MMSE scores, improving the comparability of these cognitive screening tools for use in clinical and research purposes.

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One Size Does Not Fit All: Comparative Diagnostic Accuracy of the Rowland Universal Dementia Assessment Scale and the Mini Mental State Examination in a Memory Clinic Population with Very Low Education

Cited by 42 publications

References 54 publications

Cross-cultural dementia screening using the Rowland Universal Dementia Assessment Scale: a systematic review and meta-analysis

Cross-cultural dementia screening using the Rowland Universal Dementia Assessment Scale: a systematic review and meta-analysis

Neuropsychological assessment in the multicultural memory clinic: development and feasibility of the TULIPA battery

Conversion between the Rowland Universal Dementia Assessment Scale and Mini‐Mental State Examination test scores in majority and minority populations

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