Thursday, 21 August 2003
This presentation is part of : IPA Awards for Research in Psychogeriatrics

KP005-001 The Rowland Universal Dementia Assessment Scale (RUDAS): A Multicultural Cognitive Assessment Scale

Joella Elizabeth Storey1, Jeffrey Thomas John Rowland2, David Basic2, David Anthony Conforti2, and Hugh Grant Dickson3. (1) Geriatrics and Rehabilitation, University of New South Wales and Liverpool Health Service, Sydney, Australia, (2) Geriatrics and Rehabilitation, Liverpool Health Service, Sydney, Australia, (3) Division of Medicine, University of New South Wales and Liverpool Health Service, Sydney, Australia

OBJECTIVE: To develop and validate a simple method for detecting dementia that is valid across cultures, portable and easily administered by primary health care clinicians. DESIGN: Culture and Health Advisory Groups were used in Stage 1 to develop culturally fair cognitive items. In Stage 2, clinical testing of 42 items was conducted in a multicultural sample of consecutive new referrals to the Geriatric Medicine outpatient clinic at Liverpool Hospital, Sydney, Australia (n = 166). In Stage 3, the predictive accuracy of items was assessed in a random sample of community-dwelling elderly persons stratified by language background and cognitive diagnosis and matched for sex and age (n = 90). MEASUREMENTS: A research psychologist administered all cognitive items using interpreters when needed. Each patient was comprehensively assessed by one of three geriatricians, who ordered relevant investigations, and implemented a standardised assessment of cognitive domains. The geriatricians also collected demographic information, and administered other functional and cognitive measures. DSM-IV criteria were used to assign cognitive diagnoses. Item validity and weights were assessed using frequency and logistic regression analyses. ROC curve analysis was used to determine overall predictive accuracy of the RUDAS and the best cut point for detecting cognitive impairment. RESULTS: The 6-item RUDAS assesses multiple cognitive domains including memory, praxis, language, judgement, drawing and body orientation. It appears not to be affected by gender, years of education, differential performance factors and preferred language. The area under the ROC curve for the RUDAS was 0.94 (95% CI 0.87-0.98). At a cut point of 23 (maximum score of 30), sensitivity and specificity were 89% and 98%, respectively. Inter-rater (0.99) and test-retest (0.98) reliabilities were very high. CONCLUSIONS: The 6-item RUDAS is portable and tests multiple cognitive domains. It is easily interpreted to other languages, and appears to be culturally fair. However, further validation is needed in other settings, and in longitudinal studies to determine its sensitivity to change in cognitive function over time.

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