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This is a case of a patient affected by Cushing syndrome that was admitted at the hospital due to hormonal problems. He had presented psychiatric symptoms that were mistakenly considered not directly connected to the pathology causing the clinical condition, but a mere psychological reaction to it.

IntroductionPrimary Health Care (PHC) has an essential role in the early detection of people with cognitive impairment (CI). Rowland Universal Dementia Assessment Scale (RUDAS) is a brief cognitive test, appropriate for people with minimum completed level of education and easily adaptable to multicultural contexts. For these reasons it could be a good instrument for dementia screening in PHC. It comprises the following areas: recent memory, body orientation, praxis, executive functions and language.ObjectivesThe objective of this study was to analyse the viability of RUDAS, as an instrument for the screening of CI in PHC. RUDAS viability in PHC was checked, and it's psychometric properties assessed: Reliability, Sensitivity, Specificity, Positive and Negative Predictive Value were studied. RUDAS was compared to Mini Mental State Exam (MMSE) as a “gold standard”.Patients and MethodsRUDAS was administered to 150 participants older than 65 years, randomly selected from seven PHC physicians’ consultations in O Grove Health Center. The test battery also included Katz, Barthel and Lawton Indexes, MMSE and the Geriatric Depression Scale. For each instrument administration time, difficulties perceived while administration and participant's collaboration were recorded. RUDAS was administered again within one month to assess test-retest reliability. For dementia clinical diagnosis, patients were classified following the Clinical Dementia Rating (CDR) scale based on clinicians’ criteria and health records.ResultsRUDAS application was brief (7,58±2,10 minutes) and well accepted. RUDAS’ area under Receiver Operating Characteristic (ROC) curve was 0.965 (95% Confidence Interval (CI) = 0.91-1.00) for an optimal cut-off point of 21.5, with sensitivity of 90.0%, and a specificity of 94.1%. RUDAS did not correlate with depression. Education, socioeconomic status and urban or rural context did not contribute any variance to RUDAS total score.ConclusionsRUDAS is a valid instrument to assess CI in PHC. It is easily applicable and appears to be culturally fair and free from educational level and language interference in bilingual contexts. However, longitudinal studies to determine its sensitivity to change in cognitive function over time are needed.

Background:Rowland Universal Dementia Assessment Scale (RUDAS) is a brief cognitive test, appropriate for people with minimum completed level of education and sensitive to multicultural contexts. It could be a good instrument for cognitive impairment (CI) screening in Primary Health Care (PHC). It comprises the following areas: recent memory, body orientation, praxis, executive functions and language.Research Objective:The objective of this study is to assess the construct validity of RUDAS analysing its internal consistency and factorial structure.Method:Internal consistency will be calculated using ordinal Cronbach’s α, which reflects the average inter-item correlation score and, as such, will increase when correlations between the items increase. Exploratory Factor Analysis will be used to arrange the variables in domains using principal components extraction. The factorial analysis will include the extraction of five factors reflecting the neuropsychological areas assessed by the test. The result will be rotated under Varimax procedure to ease interpretation.Exploratory factor analysis will be used to arrange the variables in domains using principal components extraction. The analysis will include Kaiser–Meyer–Olkin measure of sampling adequacy and Bartlett’s test of sphericity. Estimations will be based based on Pearson’s correlations between indicators using a principal component analysis and later replicated with a tetrachoric correlation matrix. The variance in the tetrachoric model will be analysed to indentify convergent iterations and their explicative power.Preliminary results of the ongoing study:RUDAS is being administered to 321 participants older than 65 years, from seven PHC physicians’ consultations in O Grove Health Center. The data collection will be finished by August 2021 and in this poster we will present the final results of the exploratory factor analysis.Conclusions:We expect that the results of the exploratory factor analysis will replicate the results of previous studies of construct validity of the test in which explanatory factor weights were between 0.57 and 0.82, and all were above 40%. Confirming that RUDAS has a strong factor construct with high factor weights and variance ratio, and 6-item model is appropriate for measurement will support its recommendation as a valid screening instrument for PHC.

for their support. In addition, the authors are especially thankful for the aid provided by the Psychiatric Nursing and Psychiatry Services of the Álvaro Cunqueiro and Nicolás Peña hospitals. Conflicts of interest:The authors report no financial or other relationship relevant to the subject of this article.Ethics approval and consent to participate: All procedures were approved by Helsinki Declaration and with the approval of the Ethics Committee (