A key study reports that the Rowland Universal Dementia Assessment Scale (RUDAS) is an effective dementia test. The study shows this is particularly true in multicultural populations, where English is not a patient’s first language.
The study was published in CMAJ (Canadian Medical Association Journal).
The Results
Popular tests used by doctors to assess cognitive health include the MMSE (Mini-Mental State Examination) and the MCA (Montreal Cognitive Assessment). Though widely used, they can be difficult and overly-challenging for patients with low education levels, as well as those whose first language is not English.
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Researchers undertook a systematic review and meta-analysis to determine whether the RUDAS, developed in Australia in 2004, is effective in a variety of settings. They also wanted to understand how it compares to other tests. The study included 1236 people from 11 previous studies conducted in 6 countries. The mean age of participants was 73.5 years, and almost two-thirds (61%) were female.
The results showed that RUDAS was consistently free of cultural and educational bias in multicultural samples.
What It Looks Like
The RUDAS includes questions such as recall of four grocery items, what safety precautions should one take when crossing the street, and naming of animals in 1 minute; it also assesses coordinated movements.
The test appeared to be effective in identifying cognitive impairment and ruling it out across various cultures because language and education had less effect on results than with the other assessment tools.
Limitations
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The authors noted that all studies included in the analysis used trained interpreters; this may be a limitation since interpreters will not always be available for tests in all settings.
RUDAS is easily interpreted by an interpreter during an assessment. Some translated versions are available but are not validated.
Conclusions
“Given our aging immigrant population… and the anticipated increase in dementia prevalence worldwide in coming decades, earlier and more accurate detection of dementia in these populations will become increasingly important,” writes Dr. Raza Naqvi, a geriatrician with the Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada, with coauthors.
“The RUDAS is a freely available, effective brief cognitive assessment tool that has shown strong psychometric properties in several countries. It shows particular advantage in culturally and linguistically diverse populations,” the authors conclude.
The Test:
- Listen to an interview with the author (Podcast): https://soundcloud.com/cmajpodcasts/naqvi-multicultural-cognitive
- RUDAS administration and scoring guide – English (PDF: 25 page booklet)
- RUDAS scoring sheet – English (PDF)
- RUDAS scoring sheet – Chinese (PDF)
- RUDAS administration and scoring guide – Italian (PDF: 25 page booklet)
- RUDAS scoring sheet – Italian (2 pages looseleaf)
MORE INFORMATION:
- Cognitive assessments in multicultural populations using the Rowland Universal Dementia Assessment Scale: a systematic review and meta-analysis , Raza M. Naqvi, Sehrish Haider, George Tomlinson, Shabbir Alibhai. CMAJ, DOI:10.1503/cmaj.140802.
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