title: Validation of the Arabic Rowland Universal Dementia Assessment Scale (A-RUDAS) in elderly with mild and moderate dementia.
abstract: Validated screening tests for dementia in Arabic are lacking. Given the low levels of education among elderly in the Middle East and North Africa region, the commonly used screening instrument, the Mini Mental State Examination, is not best suited. Alternatively, the Rowland Universal Dementia Assessment Scale (RUDAS) was especially designed to minimize the effects of cultural learning and education. The aim of this study was to validate the RUDAS in the Arabic language (A-RUDAS), evaluate its ability to screen for mild and moderate dementia, and assess the effect of education, sex, age, depression, and recruitment site on its performance.
  
  
  
  A-RUDAS was administered to 232 elderly aged ≥65 years recruited from the communities, community-based primary care clinics, and hospital-based specialist clinics. Of these, 136 had normal cognition, and 96 had dementia. Clinicians diagnosed dementia according to the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) criteria. Interviewers, blind to the cognitive status of participants, administered A-RUDAS. The psychometric properties of A-RUDAS were examined for three cutoffs.
  
  
  
  At the cutoff of ≤22, A-RUDAS exhibited good sensitivity (83%) and specificity (85%) with an area under the receiver operating characteristic curve of 83.95%. Adjusting for age, sex, education, depression, and recruitment site, A-RUDAS score demonstrated a high level of accuracy in screening for mild and moderate dementia against DSM-IV diagnosis.
  
  
  
  The A-RUDAS is proposed for dementia screening in clinical practice and in research in Arabic-speaking populations with an optimal cutoff of ≤22.
authors.affiliation: a Department of Epidemiology and Population Health, Faculty of Health Sciences , American University of Beirut , Beirut , Lebanon.
authors.forename: M
authors.initials: M
authors.lastname: Chaaya
authors.affiliation: b Department of Neurology, Danish Dementia Research Center, The Neuroscience Center , University of Copenhagen , Copenhagen , Denmark.
authors.forename: T K T
authors.initials: TK
authors.lastname: Phung
authors.affiliation: a Department of Epidemiology and Population Health, Faculty of Health Sciences , American University of Beirut , Beirut , Lebanon.
authors.forename: K
authors.initials: K
authors.lastname: El Asmar
authors.affiliation: c Department of Neurology , American University of Beirut Medical Center , Beirut , Lebanon.
authors.forename: S
authors.initials: S
authors.lastname: Atweh
authors.affiliation: d Department of Geriatrics , American University of Beirut Medical Center , Beirut , Lebanon.
authors.forename: H
authors.initials: H
authors.lastname: Ghusn
authors.affiliation: a Department of Epidemiology and Population Health, Faculty of Health Sciences , American University of Beirut , Beirut , Lebanon.
authors.forename: R M
authors.initials: RM
authors.lastname: Khoury
authors.affiliation: e Department of Health Service and Population Research , Institute of Psychiatry , King's College London , London , UK.
authors.forename: M
authors.initials: M
authors.lastname: Prince
authors.affiliation: b Department of Neurology, Danish Dementia Research Center, The Neuroscience Center , University of Copenhagen , Copenhagen , Denmark.
authors.forename: T R
authors.initials: TR
authors.lastname: Nielsen
authors.affiliation: b Department of Neurology, Danish Dementia Research Center, The Neuroscience Center , University of Copenhagen , Copenhagen , Denmark.
authors.forename: G
authors.initials: G
authors.lastname: Waldemar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D009483:Neuropsychological Tests / Q000592:standards*; D011594:Psychometrics; D012720:Severity of Illness Index
keywords: Lebanon; RUDAS; dementia; validation