The performance of the Rowland Universal Dementia Assessment Scale (RUDAS) for cognitive screening in a geriatric outpatient setting

Abstract

Background and aims: Dementia is prevalent in the elderly but it is usually unrecognized. The Rowland Universal Dementia Assessment Scale (RUDAS) appears to be a good screening tool for dementia detection. The objectives are to validate RUDAS-Thai for detecting dementia according to Diagnostic and Statistical Manual of Mental Disorders- IV-Text Revised (DSM-IV-TR) criteria in a geriatric outpatient setting and to determine its optimal cut point.

Methods: This is a cross-sectional study in which the target population is patients from a Geriatric and Neurology Outpatient Clinic, Srinagarind Hospital, Khon Kaen University who were aged 60 years or above. The content validity and test-retest reliability of the RUDAS-Thai were performed initially. It was administered to each participant. Then a specialist physician assessed each participant for dementia.

Results: Eighty-nine (44.5%) subjects had dementia, 89 (44.5%) had normal cognition and 22 (11%) had mild cognitive impairment. The area under the Receiver operating characteristic (ROC) curve was 0.82 (0.75-0.87). The optimal cut point was 24/30; it provided sensitivity and specificity of 78.7% and 61.8%, respectively. It was not influenced by age and gender but by educational level.

Conclusions: The RUDAS-Thai is a good screening tool for dementia detection in a geriatric outpatient setting. It is portable, short-time consuming, and avoids some limitations of the Mini-Mental State Examination (MMSE). However, education does affect the scores. The scores of 24 or lower is an optimal cut point for an indication of developing dementia.