Validation of the Rowlands Universal Dementia Assessment Scale (RUDAS) to detect major neurocognitive disorder among elderly people in Ethiopia, 2020

Abstract

Background The Rowland Universal Dementia Assessment Scale (RUDAS) is currently widely used for research and clinical purposes in many countries. However, its applicability and validity have not been evaluated in the Ethiopian context so far. Therefore, we designed this study to assess the reliability and validity of Rowland Universal Dementia Assessment Scale to detect major neurocognitive disorder among older people in Ethiopia. Methods An institution-based cross-sectional study was conducted among selected older people residing in Macedonia institutional care center, Addis Ababa, Ethiopia. The gold standard diagnosis was determined using the Diagnostic and Statistical Manual of Mental Disorders criteria for major neurocognitive disorders. Stata v16 statistical software was used for data analysis. Receivers operating curve analysis, correlations, linear regression, and independent t-test were performed with statistically significant associations declared at a p-value of <0.05. Inter-rater, internal consistency reliabilities, content, criterion and construct validities were also determined. Results A total of 116 individuals participated in the study with a 100% response rate. Most (52.7%) of the participants were male and the mean age in years was 69.9± 8. The Cronbach’s alpha for RUDAS was 0.7 with an intra-class correlation coefficient value of 0.9. RUDAS has an area under the receivers operating curve of 0.87 with an optimal cutoff value of ≤ 22. At this cutoff point, RUDAS has sensitivity and specificity of 92.3 and 75.3 with positive and negative likelihood ratios as well as positive and negative predictive values of 3.7, 0.1, 65.5%, and 91.5%, respectively. There has also been a significant difference in the mean scores of RUDAS among the two diagnostic groups showing good construct validity. Conclusion The Rowland Universal Dementia Assessment Scale has been demonstrated to be a valid and reliable tool to detect major neurocognitive disorder. Policy makers and professionals can incorporate the tool in clinical and research practices in developing countries.

Cognitive decline assessment in speakers of understudied languages

“…In another study, native English speakers outperformed non‐native English speakers on several neuropsychological tests, 10 suggesting that delivering tasks in a non‐native language might negatively impact test performance. Similar observations have been reported for many other populations with diverse linguistic abilities, leading to the development of different language‐specific versions of these neuropsychological tests 11–17 . In this context, a plain translation of such tests might not be enough, that is, the transcripted word in another language might have a slightly different conceptual meaning and can bias test results.…”

Psychometric Properties of the Montreal Cognitive Assessment (MoCA) to Detect Major Neurocognitive Disorder Among Older People in Ethiopia: A Validation Study

“…The study was part of a larger study, and a further description of the methods can be found in another publication by the same authors. 18…”

“…A full description of the diagnostic criteria can be referred to from the APA's manual or in other publications. 1,18 Geriatrics Depression Scale (GDS) short form, a 15-item self-report measure by Yesavage et al with Yes/No questions, was used to assess depression. 21,22 The tool has also been applied among the Ethiopian older adults and was reported to have good internal consistency.…”

Gendered differences in the prevalence and associated factors of dementia in Ghana: a cross-sectional survey

“…Higher score indicated superior performance, whereas lower scores indicated poorer cognitive ability or dementia risk. Though not yet validated in Ghana, the RUDAS is a culturally neutral tool that has been used worldwide in Asia, Europe, and Africa [ 11 ]. Hence, its usage within the Ghanaian context was acceptable.…”

“…Hence, its usage within the Ghanaian context was acceptable. The psychometric properties of RUDAS have remained moderate to strong over time and across many cultures [ 12 , 13 ]. For this study, calculated Cronbach’s alpha estimating RUDAS’ reliability was an acceptable value of 0.71, according to conventional cut-offs [ 14 ].…”