TY - JOUR

T1 - Cross-cultural dementia screening using the Rowland Universal Dementia Assessment Scale

T2 - A systematic review and meta-analysis

AU - Nielsen, T. R.

AU - Jorgensen, Kasper

N1 - Publisher Copyright: © International Psychogeriatric Association 2020.

PY - 2020/3/9

Y1 - 2020/3/9

N2 - Objectives: To quantitatively synthesize data on the accuracy of the Rowland Universal Dementia Assessment Scale (RUDAS) in different sociocultural settings and compare its performance to other brief screening instruments for the detection of dementia.Design: Systematic review and meta-analysis. Literature searches were performed in PubMed, EMBASE, and CINAHL from January 1, 2004 until September 1, 2019.Setting: Community, outpatient clinic, and hospital settings in high-, and low- and middle-income countries.Participants: Twenty-six studies reporting diagnostic accuracy of the RUDAS were included with almost 4000 participants, including approximately 1700 patients with dementia.Measurements: Procedures for translation and cultural adaption of the RUDAS, and influence of demographic variables on diagnostic accuracy, were compared across studies. Bivariate random-effects models were used to pool sensitivity and specificity results, and diagnostic odds-ratios and the area under the hierarchical summary receiver operator characteristic curve were used to present the overall performance.Results: The pooled sensitivity and specificity for the detection of dementia were.82 (95% CI,.78-.86) and.83 (95% CI,.78-.87), respectively, with an area under the curve of.89. Subgroup analyses revealed that the RUDAS had comparable diagnostic performances across high-, and low- and middle-income settings (z =.63, P =.53) and in samples with a lower and higher proportion of participants with no formal education (z = -.15, P =.88). In 11 studies making direct comparison, the diagnostic performance of the RUDAS was comparable to that of the Mini-Mental State Examination (z = -.82, P =.41), with areas under the curve of.88 and.84, respectively.Conclusions: The RUDAS has good diagnostic performance for detecting dementia in different sociocultural settings. Compared to other brief screening instruments, advantages of the RUDAS include its limited bias in people with limited or no formal education and a minimal need for cultural or language adaptation.

AB - Objectives: To quantitatively synthesize data on the accuracy of the Rowland Universal Dementia Assessment Scale (RUDAS) in different sociocultural settings and compare its performance to other brief screening instruments for the detection of dementia.Design: Systematic review and meta-analysis. Literature searches were performed in PubMed, EMBASE, and CINAHL from January 1, 2004 until September 1, 2019.Setting: Community, outpatient clinic, and hospital settings in high-, and low- and middle-income countries.Participants: Twenty-six studies reporting diagnostic accuracy of the RUDAS were included with almost 4000 participants, including approximately 1700 patients with dementia.Measurements: Procedures for translation and cultural adaption of the RUDAS, and influence of demographic variables on diagnostic accuracy, were compared across studies. Bivariate random-effects models were used to pool sensitivity and specificity results, and diagnostic odds-ratios and the area under the hierarchical summary receiver operator characteristic curve were used to present the overall performance.Results: The pooled sensitivity and specificity for the detection of dementia were.82 (95% CI,.78-.86) and.83 (95% CI,.78-.87), respectively, with an area under the curve of.89. Subgroup analyses revealed that the RUDAS had comparable diagnostic performances across high-, and low- and middle-income settings (z =.63, P =.53) and in samples with a lower and higher proportion of participants with no formal education (z = -.15, P =.88). In 11 studies making direct comparison, the diagnostic performance of the RUDAS was comparable to that of the Mini-Mental State Examination (z = -.82, P =.41), with areas under the curve of.88 and.84, respectively.Conclusions: The RUDAS has good diagnostic performance for detecting dementia in different sociocultural settings. Compared to other brief screening instruments, advantages of the RUDAS include its limited bias in people with limited or no formal education and a minimal need for cultural or language adaptation.

KW - cognitive testing

KW - dementia

KW - Key words: Cross-cultural

KW - review and meta-analysis

KW - Rowland Universal Dementia Assessment Scale

U2 - 10.1017/S1041610220000344

DO - 10.1017/S1041610220000344

M3 - Review

C2 - 32146910

AN - SCOPUS:85081962649

VL - 32

SP - 1031

EP - 1044

JO - International Psychogeriatrics

JF - International Psychogeriatrics

SN - 1041-6102

IS - 9

ER -