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

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. (C) 2012, Editrice Kurtis