title: Cognitive assessments in multicultural populations using the Rowland Universal Dementia Assessment Scale: a systematic review and meta-analysis.
abstract: BACKGROUND
  Canada has a growing multinational immigrant population. Many commonly used cognitive assessment tools have known cultural biases and are difficult to use in ethnically diverse patient populations. The Rowland Universal Dementia Assessment Scale (RUDAS) is a cognitive assessment tool that was created for culturally and linguistically diverse populations. We performed a systematic review and meta-analysis to assess the psychometric characteristics of the RUDAS and to compare it with other available tools.
  
  
  METHODS
  We identified studies that assessed the psychometric properties of the RUDAS compared with a reference standard for diagnosing dementia or compared the RUDAS to other cognitive assessment tools. Two independent reviewers screened the abstracts and full-text articles and reviewed bibliographies for further references. We extracted data using standardized forms and assessed studies for risk of bias.
  
  
  RESULTS
  Our search resulted in 148 articles, from which 11 were included. The RUDAS was assessed in 1236 participants and was found to have a pooled sensitivity of 77.2% (95% confidence interval [CI] 67.4-84.5) and a pooled specificity of 85.9% (95% CI 74.8-92.6) yielding a positive likelihood ratio of 5.5 (95% CI 2.9-10.7) and a negative likelihood ratio of 0.27 (95% CI 0.17-0.40). A pooled estimate of the correlation between the RUDAS and the Mini-Mental State Examination (MMSE) was 0.77 (95% CI 0.72-0.81). Results of the RUDAS were less affected by language and education level than the MMSE.
  
  
  CONCLUSIONS
  The RUDAS is a brief and freely available cognitive assessment tool with reasonable psychometric characteristics that may be particularly useful in patients with diverse backgrounds.
authors.affiliation: Department of Medicine (Naqvi), and Health and Rehabilitation Sciences (Haider), Western University, London, Ont.; Department of Medicine, and Institute of Health Policy, Management and Evaluation (Tomlinson, Alibhai), University of Toronto, Toronto, Ont. raza.naqvi@lhsc.on.ca.
authors.forename: Raza M
authors.initials: RM
authors.lastname: Naqvi
authors.affiliation: Department of Medicine (Naqvi), and Health and Rehabilitation Sciences (Haider), Western University, London, Ont.; Department of Medicine, and Institute of Health Policy, Management and Evaluation (Tomlinson, Alibhai), University of Toronto, Toronto, Ont.
authors.forename: Sehrish
authors.initials: S
authors.lastname: Haider
authors.affiliation: Department of Medicine (Naqvi), and Health and Rehabilitation Sciences (Haider), Western University, London, Ont.; Department of Medicine, and Institute of Health Policy, Management and Evaluation (Tomlinson, Alibhai), University of Toronto, Toronto, Ont.
authors.forename: George
authors.initials: G
authors.lastname: Tomlinson
authors.affiliation: Department of Medicine (Naqvi), and Health and Rehabilitation Sciences (Haider), Western University, London, Ont.; Department of Medicine, and Institute of Health Policy, Management and Evaluation (Tomlinson, Alibhai), University of Toronto, Toronto, Ont.
authors.forename: Shabbir
authors.initials: S
authors.lastname: Alibhai
mesh_terms: D018864:Cultural Diversity; D003704:Dementia / Q000175:diagnosis* / Q000208:ethnology; D005006:Ethnicity; D006801:Humans; D007802:Language; D015233:Models, Statistical; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012044:Regression Analysis; D012680:Sensitivity and Specificity