Validation of the Malay Version of Rowland Universal Dementia Assessment Scale (MRUDAS) among Elderly Attending Primary Care Clinic

Shaaban, Juwita; Aziz, Aniza Abdul; Abdullah, Zorina; Ab Razak, Asrenee
October 2013
International Medical Journal;Oct2013, Vol. 20 Issue 5, p555
Academic Journal
Introduction: Dementia is age prevalent neurogenerative condition which significantly affects functional ability and quality of life of patient and caregivers. Thus, it is important to produce a good tool to detect dementia. Objective: To determine the validity and reliability of Malay Version Rowland Universal Dementia Assessment Scale (M_RUDAS) for screening of dementia among elderly Method: A cross sectional study involving 49 randomly selected elderly patient attending primary care clinic was conducted from January to February 2010. Interviewer-guided method was applied using 3 questionnaires namely the M_RUDAS, the Malay version Mini Mental State Examination (M_MMSE) and Elderly Cognitive Assessment Questionnaire (M_ECAQ). The translation and content validity process were conducted with involvement of a psychiatrist and a family medicine specialist. Face validity involved two patients, two laymen and two doctors. The Pearson Correlation analysis of M_RUDAS was compared against the M_MMSE and M_ECAQ to assess the criterion validity. Intra-rater reliability of the M_RUDAS was measured using the intraclass correlation coefficient (ICC). The diagnostic accuracy of each instrument was compared against the DSM- IV TR Classification (gold standard) using the Receiver Operating Characteristic (ROC) curve analysis. Results: Majority of the subjects was Malay (98.0%) and married (88.1%). Almost one third was female (64.3%) and had educational level up primary school (61.2%). Their median age (IQR) was 68 (5) years. According to DSM-IV criteria, 79.6% were normal and 20.4% had dementia. M_RUDAS has significant and moderately correlated with M_MMSE but not ECAQ. The correlation between the M_RUDAS with M_MMSE and M_ECAQ was 0.63 (p value < 0.001) and 0.21 (p value 0.145) respectively. The intra-rater reliability of the M_RUDAS was satisfactory (ICC of the total score = 0.71). The positive likelihood ratio (LR) of M_RUDAS for dementia diagnosis at cut point less than 23/30 was 4.3, and negative LR was 0.57. M_RUDAS showed a higher area under the ROC curve (AUC) than M_MMSE and M_ECAQ. The AUC for the M_RUDAS was 0.64 [95% confidence interval (95% CI): 0.41, 0.86], M_ECAQ was 0.62 [95% CI: 0.42, 0.83] and M_MMSE was 0.59 [95% CI: 0.38, 0.81]. Conclusion: M_RUDAS had a good validity and reliability. It was comparable with MMSE and ECAQ in diagnosing dementia.


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