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

Abstract

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. 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. 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. 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.