As people age they increase the likelihood that they will suffer some form of dementing illness. With the increasing availability of services and medications it is important to be able to screen for the presence of cognitive impairment, so that it might be addressed from an earlier stage. In order to do this, doctors employ a variety of ‘screening tools’, the most common of which has been the Folstein Mini- Mental State Examination (MMSE).
In Australia a significant and ever growing proportion of the elderly population are overseas born with English as a second language. Unfortunately this can make the MMSE difficult to use as many of the concepts do not easily translate into other languages. In the South West of Sydney a group of dedicated health workers have developed a new tool: the Rowland Universal Dementia Assessment Scale – (RUDAS). This tool was developed and then validated in the very multicultural population of South West Sydney. The original studies were published showing a high degree of accuracy with the new test, at least as good as the MMSE. The studies also showed that there was little if any bias from language spoken or level of education, unlike the bias noted with the MMSE.
Most of the original researchers have recently teamed up with colleagues in Melbourne, at NARI (the National Ageing Research Institute), and in Adelaide, at the Royal Adelaide Hospital, to conduct further validation of the RUDAS. This time the RUDAS was examined in populations away from the city in which it was first developed. The population studied also had higher cognitive function, suffering a milder degree of dementia and therefore posing a more difficult task to screen for the presence of impairment. The RUDAS was compared with the MMSE and the GP-cog (General Practitioner test of cognition) against the diagnosis made by a specialist.
In terms of the primary aims of the project, the RUDAS was found to have high predictive accuracy in a broader population sample, that included other settings (Melbourne and Adelaide) and a range of cognitive function (including mild to moderate cognitive impairment). In terms of the secondary aim of the project, similar prediction accuracy between the RUDAS, MMSE and GPCOG was demonstrated.
This is very encouraging and suggests that we should be considering adopting the RUDAS across the board for screening for cognitive impairment.
Much study remains to be done.
Jeff Rowland
Staff Physician
The Prince Charles Hospital
Chermside Qld
RUDAS DVD and Supplementary Material
Online DVD
Guide to Administration and Scoring 2002, with slight revisions 2009. Running time: 20 minutes.
RUDAS Administration and Scoring Guide (25 page booklet)
(PDF file, 130 KB)
RUDAS Scoring Sheet (2 pages looseleaf)
(PDF file, 24 KB)
RUDAS Scoring Sheet - Chinese (2 pages looseleaf)
(PDF file, 488 KB, September 2009)
RUDAS Scoring Sheet - Italian (2 pages looseleaf)
(PDF file, 376 KB, September 2009)
If you wish to borrow a copy of the RUDAS DVD Guide to Administration and Scoring, Administration and Scoring Guide booklet; and the Scoring Sheet contact your local Alzheimer's Australia library service for availability.
Published Material
RUDAS Report and Journal Article Abstracts
(PDF file, 20 KB, September 2009)
RUDAS Validation Report
(PDF file 5.7 MB, January 2007)
The Rowland Universal Dementia Assessment Scale in Practise
(PDF file, 251 KB)
Presented by Dr. Jeff Rowland at the Prince Charles Hospital, QLD in March 2007 as part of the Eastern Australia Dementia Training Study Centre lecture series.
Contact Us
Alzheimer's Australia is the national peak body for people living with dementia, their families and carers and provides leadership in policy and services. To find out more, contact us or call the National Dementia Helpline on 1800 100 500.
updated: 25 November 2009
created: 18 July 2007
