The Rowland Universal Dementia Assessment Scale (RUDAS): a multicultural cognitive assessment scale
The Rowland Universal Dementia Assessment Scale (RUDAS): a multicultural cognitive assessment scale
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DOI：
10.1017/s1041610204000043
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发表时间：
2004-03-01
影响因子：
7
通讯作者：
Dickson, HG
中科院分区：
文献类型：
--
作者：
Storey, JE;Rowland, JTJ;Dickson, HG
目的：开发和验证一种检测痴呆症的简单方法，这种方法在不同文化背景下都有效，便携且易于初级卫生保健临床医生使用。设计：第一阶段采用文化与健康咨询小组开发文化公平认知项目。在第二阶段，在澳大利亚悉尼利物浦医院老年医学门诊连续新转诊的多元文化样本中进行了42项临床测试（n = 166）。在第3阶段，对社区居住老年人的随机样本进行预测准确性评估，这些老年人按语言背景和认知诊断分层，并根据性别和年龄进行匹配（n = 90）。测量：一名研究心理学家管理所有认知项目，必要时使用口译员。每位患者由三名老年病专家中的一名进行全面评估，他们下令进行相关调查，并对认知领域进行标准化评估。老年病学家还收集了人口统计信息，并进行了其他功能和认知测量。采用DSM-IV标准进行认知诊断。使用频率和逻辑回归分析评估项目效度和权重。使用受试者工作特征（ROC）曲线分析确定RUDAS的总体预测准确性和检测认知障碍的最佳切割点。结果：RUDAS测试包括记忆、实践、语言、判断、绘画和身体定向等多个认知领域。它似乎不受性别、受教育年限、不同表现因素和首选语言的影响。RUDAS的ROC曲线下面积为0.94 （95% CI 0.87-0.98）。在临界值为23（最高评分为30）时，敏感性和特异性分别为89%和98%。测间信度（0.99）和重测信度（0.98）都非常高。结论：6项RUDAS可移植，可测试多个认知领域。它很容易被翻译成其他语言，并且在文化上似乎是公平的。然而，需要在其他环境中进一步验证，并在纵向研究中确定其对认知功能随时间变化的敏感性。
Objective: To develop and validate a simple method for detecting dementia that is valid across cultures, portable and easily administered by primary health care clinicians.Design: Culture and Health Advisory Groups were used in Stage I to develop culturally fair cognitive items. In Stage 2, clinical testing of 42 items was conducted in a multicultural sample of consecutive new referrals to the geriatric medicine outpatient clinic at Liverpool Hospital, Sydney, Australia (n = 166). In Stage 3, the predictive accuracy of items was assessed in a random sample of community-dwelling elderly persons stratified by language background and cognitive diagnosis and matched for sex and age (n = 90).Measurements: A research psychologist administered all cognitive items, using interpreters when needed. Each patient was comprehensively assessed by one of three geriatricians, who ordered relevant investigations, and implemented a standardized assessment of cognitive domains. The geriatricians also collected demographic information, and administered other functional and cognitive measures. DSM-IV criteria were used to assign cognitive diagnoses. Item validity and weights were assessed using frequency and logistic regression analyses. Receiver-operating characteristic (ROC) curve analysis was used to determine overall predictive accuracy of the RUDAS and the best cut-point for detecting cognitive impairment.Results: The 6-item RUDAS assesses multiple cognitive domains including memory, praxis, language, judgement, drawing and body orientation. It appears not to be affected by gender, years of education, differential performance factors and preferred language. The area under the ROC curve for the RUDAS was 0.94 (95% CI 0.87-0.98). At a cut-point of 23 (maximum score of 30), sensitivity and specificity were 89% and 98%, respectively. Inter-rater (0.99) and test-retest (0.98) reliabilities were very high.Conclusions: The 6-item RUDAS is portable and tests multiple cognitive domains. It is easily interpreted to other languages, and appears to be culturally fair. However, further validation is needed in other settings, and in longitudinal studies to determine its sensitivity to change in cognitive function over time.