Validación del RUDAS como instrumento de cribado de población con demencia en atención primaria / Validation of RUDAS: A screening tool for dementia in Primary Health Care settings

Objetivo: Validar la escala Rowland Dementia Assessment Scale (RUDAS) como instrumento de cribado de deterioro cognitivo y demencia en atención primaria (AP). Es un test breve, válido para población con bajo nivel educativo formal y fácilmente traducible en entornos multiculturales. Diseño: Se realizó un estudio epidemiológico descriptivo, de corte transversal, con seguimiento a los 5años. Emplazamiento: Centro de salud de atención primaria de O Grove, que atiende a una población de 10.650 habitantes en Pontevedra. Participantes: Ciento cincuenta personas aleatoriamente seleccionadas, con una edad media de 76,35±7,12años, bajo nivel educativo, origen predominantemente rural y semirrural y nivel socioeconómico bajo. Intervención: Se analizó la viabilidad, la aceptabilidad, la validez y la fiabilidad de la escala. Mediciones principales: RUDAS, Mini Mental State Examination, Clinical Dementia Rating, Índice de Katz, Índice de Barthel, Índice de Lawton y Escala de Depresión Geriátrica de Yesavage. Resultados: El test fue bien acogido por los pacientes y rápido de aplicar (7,58±2,10min). El área bajo la curva COR para el diagnóstico de demencia fue 0,983 (IC95%: 0,97-1,00). Para un punto de corte óptimo de 22,5 presentó una sensibilidad del 89,3% y una especificidad del 100%. El área bajo la curva COR para discriminar personas con DCL de personas con demencia fue 0,965 (IC95%: 0,91-1,00). Conclusiones: El RUDAS ha demostrado ser un instrumento viable y eficiente para cribar demencias en AP, libre de influencias educativas y socioculturales. Es especialmente sensible para discriminar población con deterioro cognitivo leve de población con demencia.(AU)

Objective: To validate Rowland Dementia Assessment Scale (RUDAS), as an instrument for the screening of people with dementia and cognitive impairment in Primary Health Care (PHC). RUDAS is a brief cognitive test, appropriate for people with minimum completed level of education and easily adaptable to multicultural contexts. For these reason it could be a good instrument for dementia screening in PHC. Design: Cross-sectional descriptive epidemiological study with a five-year follow up. Location: O Grove PHC centre, Galicia, Spain (covering a population of 10,650 individuals). Outcome measures: RUDAS; Mini Mental State Examination; Clinical Dementia Rating; Katz, Barthel and Lawton Indexes; MMSE and Yesavage Geriatric Depression Scale. Participants: A total of 150 older adults (mean age 76.35±7.12years) randomly selected, from a low sociocultural and economical background and mainly rural and semirural origin. Intervention: RUDAS viability in PHC was checked, and its psychometric properties assessed: reliability, sensitivity, specificity, positive and negative predictive values. Results: RUDAS application was brief (7.58±2.10min) and well accepted. RUDAS area under receiver operating characteristic (ROC) curve for the detection of dementia was 0.983 (95% confidence interval (CI): 0.97-1.00) for an optimal cut-off point of 22.5, with sensitivity of 89.3%, and a specificity of 100%. Area under ROC curve for discriminating dementia from mild cognitive impairment was 0.965 (95%CI: 0.91-1.00). Conclusions: RUDAS test is fit for dementia screening in PHC and it is especially sensitive to discriminate PWD from people with MCI.(AU)

[Validation of RUDAS: A screening tool for dementia in Primary Health Care settings]. / Validación del RUDAS como instrumento de cribado de población con demencia en atención primaria.

OBJECTIVE: To validate Rowland Dementia Assessment Scale (RUDAS), as an instrument for the screening of people with dementia and cognitive impairment in Primary Health Care (PHC). RUDAS is a brief cognitive test, appropriate for people with minimum completed level of education and easily adaptable to multicultural contexts. For these reason it could be a good instrument for dementia screening in PHC. DESIGN: Cross-sectional descriptive epidemiological study with a five-year follow up. LOCATION: O Grove PHC centre, Galicia, Spain (covering a population of 10,650 individuals). OUTCOME MEASURES: RUDAS; Mini Mental State Examination; Clinical Dementia Rating; Katz, Barthel and Lawton Indexes; MMSE and Yesavage Geriatric Depression Scale. PARTICIPANTS: A total of 150 older adults (mean age 76.35±7.12years) randomly selected, from a low sociocultural and economical background and mainly rural and semirural origin. INTERVENTION: RUDAS viability in PHC was checked, and its psychometric properties assessed: reliability, sensitivity, specificity, positive and negative predictive values. RESULTS: RUDAS application was brief (7.58±2.10min) and well accepted. RUDAS area under receiver operating characteristic (ROC) curve for the detection of dementia was 0.983 (95% confidence interval (CI): 0.97-1.00) for an optimal cut-off point of 22.5, with sensitivity of 89.3%, and a specificity of 100%. Area under ROC curve for discriminating dementia from mild cognitive impairment was 0.965 (95%CI: 0.91-1.00). CONCLUSIONS: RUDAS test is fit for dementia screening in PHC and it is especially sensitive to discriminate PWD from people with MCI.