The Rowland Universal Dementia Assessment Scale (RUDAS) and the Folstein MMSE in a multicultural cohort of elderly persons

2006 ◽  
Vol 18 (1) ◽  
pp. 111-120 ◽  
Author(s):  
Jeffrey T. Rowland ◽  
David Basic ◽  
Joella E. Storey ◽  
David A. Conforti
Keyword(s):  
Rating Scale ◽  
Characteristic Curve ◽  
Positive Likelihood Ratio ◽  
Language Education ◽  
Community Dwelling ◽  
Assessment Scale ◽  
Elderly Persons ◽  
Likelihood Ratios ◽  
Clinical Dementia Rating ◽  
And Gender

Objective: To compare the accuracy of the Rowland Universal Dementia Assessment Scale (RUDAS) and the Folstein Mini-mental State Examination (MMSE) for diagnosis of dementia in a multicultural cohort of elderly persons.Methods: A total of 129 community-dwelling persons were selected at random from a database of referrals to an aged-care team. Subjects were stratified according to language background and cognitive diagnosis, and matched for age and gender. The RUDAS and the MMSE were administered to each subject in random order. Within several days, a geriatrician assessed each subject for dementia (DSM-IV criteria) and disease severity (Clinical Dementia Rating Scale). All assessments were carried out independent and blind. The geriatrician also administered the Modified Barthel Index and the Lawton Instrumental Activities of Daily Living Scale, and screened all participants for non-cognitive disorders that might affect instrument scores.Results: The area under the receiver operating characteristic curve (AUC) for the RUDAS [0.92, 95% confidence interval (95%CI) 0.85–0.96] was similar to the AUC for the MMSE (0.91, 95%CI 0.84–0.95). At the published cut-points (RUDAS < 23/30, MMSE < 25/30), the positive and negative likelihood ratios for the RUDAS were 19.4 and 0.2, and for the MMSE 2.1 and 0.14, respectively. The MMSE, but not the RUDAS, scores were influenced by preferred language (p = 0.015), total years of education (p = 0.016) and gender (p = 0.044).Conclusions: The RUDAS is at least as accurate as the MMSE, and does not appear to be influenced by language, education or gender. The high positive likelihood ratio for the RUDAS makes it particularly useful for ruling-in disease.

The Rowland Universal Dementia Assessment Scale (RUDAS): a multicultural cognitive assessment scale

2004 ◽  
Vol 16 (1) ◽  
pp. 13-31 ◽  
Author(s):  
Joella E. Storey ◽  
Jeffrey T. J. Rowland ◽  
David A. Conforti ◽  
Hugh G. Dickson
Keyword(s):  
Roc Curve ◽  
Predictive Accuracy ◽  
Geriatric Medicine ◽  
Community Dwelling ◽  
Assessment Scale ◽  
Elderly Persons ◽  
Roc Curve Analysis ◽  
Simple Method ◽  
Cognitive Domains ◽  
Cut Point

Objective: To develop and validate a simple method for detecting dementia that is valid across cultures, portable and easily administered by primary health care clinicians.Design: Culture and Health Advisory Groups were used in Stage 1 to develop culturally fair cognitive items. In Stage 2, clinical testing of 42 items was conducted in a multicultural sample of consecutive new referrals to the geriatric medicine outpatient clinic at Liverpool Hospital, Sydney, Australia (n=166). In Stage 3, the predictive accuracy of items was assessed in a random sample of community-dwelling elderly persons stratified by language background and cognitive diagnosis and matched for sex and age (n=90).Measurements: A research psychologist administered all cognitive items, using interpreters when needed. Each patient was comprehensively assessed by one of three geriatricians, who ordered relevant investigations, and implemented a standardized assessment of cognitive domains. The geriatricians also collected demographic information, and administered other functional and cognitive measures. DSM-IV criteria were used to assign cognitive diagnoses. Item validity and weights were assessed using frequency and logistic regression analyses. Receiver-operating characteristic (ROC) curve analysis was used to determine overall predictive accuracy of the RUDAS and the best cut-point for detecting cognitive impairment.Results: The 6-item RUDAS assesses multiple cognitive domains including memory, praxis, language, judgement, drawing and body orientation. It appears not to be affected by gender, years of education, differential performance factors and preferred language. The area under the ROC curve for the RUDAS was 0.94 (95% CI 0.87–0.98). At a cut-point of 23 (maximum score of 30), sensitivity and specificity were 89% and 98%, respectively. Inter-rater (0.99) and test-retest (0.98) reliabilities were very high.Conclusions: The 6-item RUDAS is portable and tests multiple cognitive domains. It is easily interpreted to other languages, and appears to be culturally fair. However, further validation is needed in other settings, and in longitudinal studies to determine its sensitivity to change in cognitive function over time.

Control Beliefs of the Frail Elderly: Assessing Differences Between Homebound and Nursing Home Residents

2001 ◽  
Vol 3 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Madeleine Grain
Keyword(s):  
Life Satisfaction ◽  
Nursing Home ◽  
Rating Scale ◽  
Nursing Home Residents ◽  
Personal Control ◽  
Community Dwelling ◽  
Elderly Persons ◽  
Sense Of Control ◽  
Age Related ◽  
Dependent Samples

Previous age-related sense of control studies have largely focused on active, community-dwelling aged individuals and have excluded elderly persons who are frail. This study compares sense of control and life satisfaction as determined through rating scale administration between two frail, dependent samples: nursing home residents and homebound elderly. Differences in control scores were statistically significant for those who were homebound expressing higher perceived personal control than nursing home residents (p < .001). Sense of control has no correlation with either life satisfaction or length of stay in the nursing home cohort.

scholarly journals Neuropsychological Profiles Differentiate Alzheimer Disease from Subcortical Ischemic Vascular Dementia in an Autopsy-Defined Cohort

2017 ◽  
Vol 44 (1-2) ◽  
pp. 1-11 ◽  
Author(s):  
Liliana Ramirez-Gomez ◽  
Ling Zheng ◽  
Bruce Reed ◽  
Joel Kramer ◽  
Dan Mungas ◽  
...  
Keyword(s):  
Alzheimer Disease ◽  
Vascular Dementia ◽  
Neuropsychological Tests ◽  
Rating Scale ◽  
Word Association ◽  
Positive Likelihood Ratio ◽  
Operating Characteristics ◽  
Clinical Dementia Rating ◽  
Or Education ◽  
Learning Test

Background/Aims: The aim of this study was to assess the ability of neuropsychological tests to differentiate autopsy-defined Alzheimer disease (AD) from subcortical ischemic vascular dementia (SIVD). Methods: From a sample of 175 cases followed longitudinally that underwent autopsy, we selected 23 normal controls (NC), 20 SIVD, 69 AD, and 10 mixed cases of dementia. Baseline neuropsychological tests, including Memory Assessment Scale word list learning test, control oral word association test, and animal fluency, were compared between the three autopsy-defined groups. Results: The NC, SIVD, and AD groups did not differ by age or education. The SIVD and AD groups did not differ by the Global Clinical Dementia Rating Scale. Subjects with AD performed worse on delayed recall (p < 0.01). A receiver operating characteristics analysis comparing the SIVD and AD groups including age, education, difference between categorical (animals) versus phonemic fluency (letter F), and the first recall from the word learning test distinguished the two groups with a sensitivity of 85%, specificity of 67%, and positive likelihood ratio of 2.57 (AUC = 0.789, 95% CI 0.69-0.88, p < 0.0001). Conclusion: In neuropathologically defined subgroups, neuropsychological profiles have modest ability to distinguish patients with AD from those with SIVD.

scholarly journals Prevalence of dementia among widowed and non-widowed patients and associated clinical and sociodemographic characteristics

2019 ◽  
Vol 22 (2) ◽  
Author(s):  
Rodrigo Rizek Schultz ◽  
Paulo Eduardo Lahoz Fernandez ◽  
Neil Ferreira Novo ◽  
Yara Juliano ◽  
José Roberto Wajman
Keyword(s):  
Rating Scale ◽  
Age Of Onset ◽  
Sociodemographic Characteristics ◽  
Elderly Persons ◽  
Clinical Dementia Rating ◽  
Cross Sectional ◽  
Characteristics Method ◽  
The Difference ◽  
State Examination ◽  
Prevalence Of Dementia

Abstract Objective: to verify if the prevalence of dementia differs between widowed and non-widowed elderly persons and between genders, and to analyse if there is an association with sociodemographic and clinical characteristics. Method: a retrospective cross-sectional observational study of patients treated at a Behavioral Neurology outpatient clinic from 1999 to 2009 was carried out, employing anamnesis, physical and neurological examination, the Clinical Dementia Rating Scale (CDR) and the Mini Mental State Examination (MMSE). Sociodemographic (schooling and age) and clinical (age of onset of symptoms and time since onset of symptoms, MMSE and CDR) variables were analyzed. The differences were evaluated by the Mann Whitney test, using a significance value of p<0.05. Results: of 208 patients diagnosed with dementia, 73 (35.1%) were widowed and 135 (64.9%) were non-widowed. Those who were widowed were older than those who were non-widowed (p<0.001) when diagnosed with dementia. This difference in age remained when gender (p<0.001), widowed and widowed women (p<0.001) and widowed and non-widowed men (p<0.001) were compared. The time from onset of symptoms to diagnosis was greater in widowed than in non-widowed men [55.6 (± 86.3) vs. 43.4 (± 44.8) months], although the difference was not statistically significant. Widowed patients with dementia had lower schooling, regardless of gender (p<0.05). Conclusion: the prevalence of dementia differed between widowed and non-widowed individuals, being higher among non-widows. There was an association between widowhood and the clinical and sociodemographic characteristics, with differences between the genders. The loss of a spouse can generate different outcomes among men and women, necessitating measures with a specific focus on prevention and strategies of care in dementia.

scholarly journals Whole-Blood Levels of MicroRNA-9 Are Decreased in Patients With Late-Onset Alzheimer Disease

2020 ◽  
Vol 35 ◽  
pp. 153331752091157 ◽  
Author(s):  
Vinicius Carolino Souza ◽  
Gilberto Santos Morais ◽  
Adriane Dallanora Henriques ◽  
Wilcelly Machado-Silva ◽  
Diego Ignacio Valenzuela Perez ◽  
...  
Keyword(s):  
Alzheimer Disease ◽  
Whole Blood ◽  
Rating Scale ◽  
Late Onset ◽  
Community Dwelling ◽  
Disease Assessment ◽  
Blood Levels ◽  
Circulating Microrna ◽  
Clinical Dementia Rating ◽  
Blood Concentrations

Recent evidence suggests changes in circulating microRNA levels may be promising biomarkers for the clinical diagnosis of Alzheimer disease (AD). We hypothesized that whole-blood microRNAs may be useful to identify individuals with established AD. For this purpose, a sample of community-dwelling women (≥55 years old) carrying the ApoE ∊4 allele were clinically evaluated using the American Psychiatric Association/ Diagnostic and Statistical Manual of Mental Disorders, Fourth edition and the Alzheimer Disease Assessment Scale–Cognitive Subscale criteria to diagnose probable AD, and the Clinical Dementia Rating scale to stage the dementia. A set of 25 mature microRNAs was rationally selected for evaluation based on experimental evidence of interaction with genes linked to the late-onset AD neuropathology. Whole-blood concentrations were determined by quantitative real-time polymerase chain reaction. Compared to patients without dementia, a median 3-fold decrease in miR-9 levels was found among patients with AD ( P = .001). Our findings support blood-borne miR-9 as a candidate biomarker for probable AD, embodied by evidence from the literature of its implication in amyloidogenesis.

Elderly Persons' Perceptions of Humor as a Gender-Linked Characteristic

1996 ◽  
Vol 78 (1) ◽  
pp. 83-89 ◽  
Author(s):  
William F. Vitulli ◽  
Deborah L. Parman
Keyword(s):  
Rating Scale ◽  
Elderly Women ◽  
Elderly Persons ◽  
Elderly Men ◽  
Men And Women ◽  
Plot Analysis ◽  
Potential Benefits ◽  
Important Quality ◽  
And Gender ◽  
Post Hoc

Attitudes toward the role that humor is supposed to play in the repertoires of men and women may explain the extent to which elderly people avail themselves of humor's potential benefits. 96 volunteers consisting of 24 men (ages 59–90 years) and 72 women (ages 51–93 years) responded to Vitulli's Humor Rating Scale. The rating scale measured attitudes toward male-oriented humor, female-oriented humor, general humor values, and an index of “differentiation of humor by gender.” A 2 × 2 factorial (split-plot) analysis of variance suggested a possible interaction between gender of participant and gender-oriented scales. Elderly men and women agreed on “general humor values,” and they both rated humor as an important quality for men on the male-oriented rating scale, yet a post hoc Scheffé test showed a significant gender effect on the female-oriented rating scale. Elderly women perceived humor as an important quality for women, whereas elderly men did not. Cohort effects and social situations in senior citizens' living complexes may account for some of the findings.

A normative study of total scores of the CERAD neuropsychological assessment battery in an educationally diverse elderly population

2014 ◽  
Vol 26 (11) ◽  
pp. 1897-1904 ◽  
Author(s):  
Ji Young Han ◽  
Eun Hyun Seo ◽  
Dahyun Yi ◽  
Bo Kyung Sohn ◽  
Young Min Choe ◽  
...  
Keyword(s):  
Neuropsychological Assessment ◽  
Demographic Variables ◽  
Community Dwelling ◽  
Elderly Persons ◽  
Normative Study ◽  
Assessment Battery ◽  
Wide Range ◽  
And Gender ◽  
Neuropsychological Assessment Battery ◽  
State Examination

ABSTRACTBackground:This study aimed to investigate the influences of age, education, and gender on the two total scores (TS-I and TS-II) of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological assessment battery (CERAD-NP) and to provide normative information based on an analysis for a large number of elderly persons with a wide range of educational levels.Methods:In the study, 1,987 community-dwelling healthy volunteers (620 males and 1,367 females; 50–90 years of age; and zero to 25 years of education) were included. People with serious neurological, medical, and psychiatric disorders (including dementia) were excluded. All participants underwent the CERAD-NP assessment. TS-I was generated by summing raw scores from the CERAD-NP subtests, excluding Mini-Mental State Examination and Constructional Praxis (CP) recall subtests. TS-II was calculated by adding CP recall score to TS-I.Results:Both TS-I and TS-II were significantly influenced by demographic variables. Education accounted for the greatest proportion of score variance. Interaction effect between age and gender was found. Based on the results obtained, normative data of the CERAD-NP total scores were stratified by age (six overlapping tables), education (four strata), and gender.Conclusions:The normative information will be very useful for better interpretation of the CERAD-NP total scores in various clinical and research settings and for comparing individuals’ performance of the battery across countries.

scholarly journals Frequency of Parkinsonism and Parkinson Disease in African Americans in the Chicago Community

2021 ◽  
Author(s):  
Meagan Bailey ◽  
Lisa M Shulman ◽  
Diane Ryan ◽  
Bichun Ouyang ◽  
Joshua M Shulman ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cohort Studies ◽  
Rating Scale ◽  
Community Dwelling ◽  
Self Report ◽  
Older Individuals ◽  
Cognitive Differences ◽  
Disease Rating ◽  
And Gender

Abstract Background There is paucity of data about African American (AA) patients with Parkinson’s disease (PD) and parkinsonism which may precede PD in older adults. Prior studies suggest that there are lower rates of PD in the AA population, with more cognitive impairment in AA with PD. This study aimed to investigate differences in PD, parkinsonism, and cognition between White and AA populations in 3 longitudinal epidemiologic cohort studies of aging. Methods This study examined parkinsonism, PD frequency, and cognition of community-dwelling older individuals in 3 longitudinal epidemiologic cohort studies. Parkinsonism was based on an exam utilizing the modified Unified Parkinson’s Disease Rating Scale performed by a nurse. PD was based on self-report, medications used for treatment of PD, and examination findings. Cognition was assessed using 19 performance-based tests that assess 5 cognitive domains. Results AA participants were less likely to have parkinsonism compared to Whites, even with age and gender differences. Frequency of PD was not significant between groups. AA were more likely to have lower cognitive scores as compared to Whites. AA were less likely to have parkinsonism even with controlling for cognitive differences between groups. Conclusions Parkinsonian signs are present among AA in the community at lower rates than in White individuals. Cognitive profiles of AA and Whites with parkinsonism may be different, suggesting differing contributions of pathology to cognitive decline and parkinsonism between groups. Additional research is needed to understand the progression of parkinsonism to PD, as well as to understanding the cognitive differences in AA with parkinsonism.

scholarly journals A Brief Dementia Test with Subjective and Objective Measures

2015 ◽  
Vol 5 (3) ◽  
pp. 341-349 ◽  
Author(s):  
Chee-Wee Tew ◽  
Tze-Pin Ng ◽  
Chin-Yee Cheong ◽  
Philip Yap
Keyword(s):  
Rating Scale ◽  
Community Dwelling ◽  
Cognitive Test ◽  
Diagnostic Utility ◽  
Operating Characteristics ◽  
Item Recall ◽  
Clinical Dementia Rating ◽  
Mild Dementia ◽  
Dementia Patients ◽  
Dementia Rating Scale

Background: The development of an effective brief dementia test will help in the early identification of dementia. Aim: This study investigates the diagnostic utility of a brief cognitive test for dementia which combines a short subjective informant-rated questionnaire (AD8) with an objective cognitive measure (Mini-Mental State Examination, MMSE) or its subcomponents. Methods: Subjects with mild dementia (Clinical Dementia Rating Scale score ≤1) were matched with community-dwelling, cognitively intact controls. MMSE and Clinical Dementia Rating Scale were administered to all subjects, while AD8 was completed by a reliable informant. Receiver operating characteristics analysis determined the diagnostic accuracies of AD8, MMSE, and AD8 combined with MMSE (AD8+MMSE). Stepwise logistic regression identified the subcomponents of MMSE which, combined with AD8, best discriminated dementia patients from controls. Results: The AD8 (area under the curve [AUC] = 0.92, 95% confidence interval [CI] 0.89-0.95) was superior to the MMSE (AUC = 0.87, 95% CI 0.83-0.92) in discriminating mild dementia patients from controls, and AD8+MMSE (AUC = 0.95, 0.92-0.98) increased its superior discrimination over MMSE alone. AD8 combined with three-item recall and intersecting pentagon copy (AUC = 0.95, 95% CI 0.92-0.97) performed as well as AD8 combined with full MMSE. Conclusion: AD8 combined with the MMSE subcomponents three-item recall and intersecting pentagon copy has excellent diagnostic utility and is a promising brief cognitive test for early dementia.

Visual Attention Cut Points for Driver Fitness in Parkinson’s Disease

2019 ◽  
Vol 39 (4) ◽  
pp. 257-265
Author(s):  
Sherrilene Classen ◽  
Babette Brumback ◽  
Karla Crawford ◽  
Sara Jenniex
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Visual Attention ◽  
Disease Severity ◽  
Characteristic Curve ◽  
Risk Index ◽  
Community Dwelling ◽  
Cut Points ◽  
Moderate Sensitivity ◽  
And Gender

This study determined whether the Useful Field of View™ Risk Index (UFOV RI) adds value as a predictor of on-road outcomes in drivers with Parkinson’s disease (PD) when considered with age, gender, and disease severity and compared with community-dwelling older drivers (Controls). A total of 101 PD drivers and 138 Controls underwent a comprehensive driving evaluation, including an on-road assessment. Logistic regression analyses determined the associations of age, gender, visual attention, and disease severity to on-road outcomes. Receiver operating characteristic curve analyses determined the optimal UFOV RI cut points to predict on-road outcomes. Above adding age and gender, the UFOV RI alone predicted on-road outcomes in PD, while the UFOV RI and age predicted on-road outcomes in Controls. Regardless of disease severity, visual attention was more impaired in PD than in Controls. The UFOV RI cut point of 3 provided the fewest misclassifications ( n = 25) in PD. The UFOV RI is a valid screening predictor of on-road outcomes across PD drivers of different disease severity, but has moderate sensitivity and specificity.

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