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Rowland Universal Dementia Assessment Scale (RUDAS)

Name and purpose Name of the resource: Rowland Universal Dementia Assessment Scale (RUDAS) Author(s) of the resource: Storey JE, Rowland JT, Basic D, Conforti DA, Dickson HG. Please state why the resource was developed and what gap it proposes to fill: The RUDAS was developed in response to issues of cultural and educational achievement bias evident in translated versions of existing cognitive assessment tools. The aim was to create a tool that was culturally fair and could be used within a multicultural population. A 3-stage development process was undertaken to identify items which covered important domains of cognitive assessment, and which maximised psychometric, and cultural and linguistic validity. The final stage being a validation of the items in a sample of community-dwelling older persons. The result is a short cognitive assessment tool for use in culturally diverse populations. It 1 has been designed to detect dementia, and monitor cognitive function over time . Target audience (the tool is to be used by) Please check all that apply: Health service users Medical staff Carers Nursing staff Any member of an interdisciplinary team

Medical specialist, please specify: Specific allied health staff, please specify: Other, please specify: Target population/setting (to be used on/in) Is the resource targeted for a specific setting? Please check all that apply: Emergency Department Other, please specify: For which particular health service users would you use this resource (e.g. a person with suspected cognitive impairment)? Any person with suspected cognitive impairment. Structure of tool Website Pamphlet Methodology Education package Assessment tool Resource guide Video Screening tool Awareness raising resource (posters, etc) Inpatient acute Inpatient subacute Ambulatory

Other, please specify: Please state the size of the resource (e.g. number of pages, minutes to read): RUDAS is a 6-item questionnaire that covers the domains of memory, body orientation, praxis, drawing, judgement, and language. Availability and cost of tool Is the resource readily available? Is there a cost for the resource? Yes Yes No No Unknown Unknown Not applicable Not applicable

Please state how to get the resource: See: http://www.alzheimers.org.au/content.cfm?infopageid=3955 The complete package is available at a cost of $15.00 from the authors: Joella E Storey Aged Care Research Liverpool Hospital Locked Bag 7103 Liverpool BC NSW 1871 Australia The cost includes a training video, supportive documentation and scoring sheets. Applicability to rural settings and culturally and linguistically diverse populations Is the resource suitable for use in rural health services (e.g. the necessary staff are usually available in rural settings)? Yes No Unknown Not applicable Is the resource available in different languages? Yes No Unknown Not applicable

Is the content appropriate for different cultural groups?

Yes

No

Unknown

Not applicable

The RUDAS can be easily administered via an interpreter and the items are considered to be culturally fair and independent of language and education1. Person-centred principles Training requirements Does the resource adhere to/promote person-centred health care? Yes No Unknown Not applicable

Is additional training necessary to use the resource? Yes No Unknown Not applicable

If applicable, please state how extensive any training is, and what resources are required: The RUDAS comes with a training video that takes 40 minutes to complete. Administration details How long does the resource take to use? 0-5 mins 5-15 mins 15-25mins 25mins

Can the resource be used as a standalone, or must it be used in conjunction with other tools, resources, and procedures? Standalone Must be used with other resources, please specify: Can be used with other tools, please specify: Data collection and analysis Are additional resources required to collect and analyse data from the resource? Yes No Unknown Not applicable

If applicable, please state any special resources required (e.g. computer software): Sensitivity and specificity Sensitivity is the proportion of people that will be correctly identified by the tool. Specificity is the probability that an individual who does not have the condition being tested for will be correctly identified as negative. Has the sensitivity and specificity of the resource been reported? Yes No Unknown Not applicable If applicable, please state what has been reported: A recent study demonstrated that, at the optimal cut-off point of 23/30, the RUDAS had a sensitivity of 81.0% (MMSE 92.1%) and specificity of 95.8% (MMSE 79.2) for the detection of dementia2. Face Validity Does the resource appear to meet the intended purpose? Yes No Unknown Not applicable The RUDAS was developed by a team of clinicians from a variety of disciplines with expertise in dementia diagnosis and care, in consultation with representatives from a wide range of cultural and 3 linguistic groups. Patients were also consulted for reading and comprehension .

2 It has been demonstrated that scores on the RUDAS correlate strongly with the MMSE . The 3 diagnostic accuracy of RUDAS is good and is better than for the MMSE .

Reliability

Reliability is the extent to which the tool's measurements remain consistent over repeated tests of the same subject under identical conditions. Inter-rater reliability measures whether independent assessors will give similar scores under similar conditions. Has the reliability of the resource been reported? Yes No Unknown Not applicable If applicable, please state what has been reported:

1 The RUDAS has demonstrated excellent test-retest and inter-rater reliability .

Strengths

What are the strengths of the resource? Is the resource easy to understand and use? Are instructions provided on how to use the resource? Is the resource visually well presented (images, colour, font type/ size)? Does the resource use older friendly terminology (where relevant), avoiding jargon? Please state any other known strengths, using dot points: · Items in the RUDAS are considered to be widely applicable to people from culturally and 4 linguistically diverse (CALD) backgrounds . · The RUDAS performs at least as well as the MMSE, in fact the RUDAS evaluates executive

function, something that the MMSE does not do. · · The RUDAS comprises a range of response formats (verbal, non-verbal, written, and praxic), which provides a comprehensive evaluation of an individual's cognitive function. A study to validate the RUDAS (in two populations outside the Sydney area where it was developed) was recently undertaken by the National Ageing Research Institute (NARI). The RUDAS performed well in the broader population and was able to detect mild cognitive impairment (see http://www.mednwh.unimelb.edu.au/research/dementia.htm). This RUDAS has been included in the Dementia Outcomes Measurement Suite developed by 3 the Centre for Health Service Development, University of Wollongong .

·

Limitations

What are the limitations of the tool/resource? Is the tool/resource difficult to understand and use? Are instructions provided on how to use the tool/resource? Is the tool/resource poorly presented (images, colour, font type/ size)? Does the tool/resource use difficult to understand jargon? Please state any other known limitations, using dot points: · Although it was developed to be used to monitor cognitive status over time, there is currently no published information on the sensitivity of RUDAS to change over time3.

References and further reading

Supporting references and associated reading 1. Storey JE, Rowland JT, Basic D, Conforti DA, Dickson HG. The Rowland Universal Dementia Assessment Scale (RUDAS): a multicultural cognitive assessment scale. International Psychogeriatrics, 2004;16(1):13-31. Rowland JT, Basic D, Storey JE, Conforti DA. The Rowland Universal Dementia Assessment Scale (RUDAS) and the Folstein MMSE in a multicultural cohort of elderly persons. International Psychogeriatrics, 2006;18(1):111-20. Sansoni J, Marosszeky N, Jeon Y-H, et al. Final Report: Dementia Outcomes Measurement Suite Project. Centre for Health Service Development, University of Wollongong. 2007. Iype T, Ajitha BK, Antony P, Ajeeth NB, Job S, Shaji KS. Usefulness of the Rowland Universal Dementia Assessment scale in South India. Journal of Neurology, Neurosurgery & Psychiatry, 2006;77(4):513-4.

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Rowland Universal Dementia Assessment Scale (RUDAS)