scholarly journals One Size Does Not Fit All: Comparative Diagnostic Accuracy of the Rowland Universal Dementia Assessment Scale and the Mini Mental State Examination in a Memory Clinic Population with Very Low Education

2018 ◽  
Vol 8 (2) ◽  
pp. 290-305 ◽  
Author(s):  
Miriam Goudsmit ◽  
Jos van Campen ◽  
Thelma Schilt ◽  
Chris Hinnen ◽  
Sanne Franzen ◽  
...  

Background: Diagnosing dementia in elderly immigrants is often difficult due to language and cultural barriers, low education, and illiteracy. We compared the diagnostic accuracy of the Rowland Universal Dementia Assessment Scale (RUDAS) to that of the Mini Mental State Examination (MMSE). Methods: A total of 144 patients (42 with intact cognition, 44 with mild cognitive impairment [MCI], and 58 with dementia) were administered both instruments and were diagnosed by specialists blinded for MMSE and RUDAS results. Results: Areas under the curve for discriminating intact cognition from MCI and dementia were comparable for RUDAS (0.81; 95% confidence interval 0.74–0.88) and MMSE (0.75; 95% confidence interval 0.69–0.85). Education and literacy were not correlated with the RUDAS but had a medium-large correlation with the MMSE (rho = 0.39). Conclusions: The study provides additional evidence for the usefulness of the RUDAS in a highly illiterate, culturally diverse geriatric outpatient population.

2012 ◽  
Vol 153 (12) ◽  
pp. 461-466 ◽  
Author(s):  
Magdolna Pákáski ◽  
Gergely Drótos ◽  
Zoltán Janka ◽  
János Kálmán

The cognitive subscale of the Alzheimer’s Disease Assessment Scale is the most widely used test in the diagnostic and research work of Alzheimer’s disease. Aims: The aim of this study was to validate and investigate reliability of the Hungarian version of the Alzheimer’s Disease Assessment Scale in patients with Alzheimer’s disease and healthy control subjects. Methods: syxty-six patients with mild and moderate Alzheimer’s disease and 47 non-demented control subjects were recruited for the study. The cognitive status was established by the Hungarian version of the Alzheimer’s Disease Assessment Scale and Mini Mental State Examination. Discriminative validity, the relation between age and education and Alzheimer’s Disease Assessment Scale, and the sensitivity and specificity of the test were determined. Results: Both the Mini Mental State Examination and the Alzheimer’s Disease Assessment Scale had significant potential in differentiating between patients with mild and moderate stages of Alzheimer’s disease and control subjects. A very strong negative correlation was established between the scores of the Mini Mental State Examination and the Alzheimer’s Disease Assessment Scale in the Alzheimer’s disease group. The Alzheimer’s Disease Assessment Scale showed slightly negative relationship between education and cognitive performance, whereas a positive correlation between age and Alzheimer’s Disease Assessment Scale scores was detected only in the control group. According to the analysis of the ROC curve, the values of sensitivity and specificity of the Alzheimer’s Disease Assessment Scale were high. Conclusions: The Hungarian version of the Alzheimer’s Disease Assessment Scale was found to be highly reliable and valid and, therefore, the application of this scale can be recommended for the establishment of the clinical stage and follow-up of patients with Alzheimer’s disease. However, the current Hungarian version of the Alzheimer’s Disease Assessment Scale is not sufficient; the list of words and linguistic elements should be selected according to the Hungarian standard in the future. Orv. Hetil., 2012, 153, 461–466.


2004 ◽  
Vol 62 (2a) ◽  
pp. 206-211 ◽  
Author(s):  
Paulo Roberto de Brito-Marques ◽  
José Eulálio Cabral-Filho

BACKGROUND: There is evidence that schooling can influence performance in cognitive assessement tests. In developing countries, formal education is limited for most people. The use of tests such as Mini-Mental State Examination (MMSE), could have an adverse effect on the evaluation of illiterate and low education individuals. OBJECTIVE: To propose a new version of MMSE as a screening test to assess Illiterate and low education people. METHOD: A study was carried out enrolling 232 individuals, aged 60 or more of low and middle socio-economic classes. Three groups were studied: Illiterate;1-4 schooling years; 5-8 schooling years. The new version (MMSEmo) consisted of modifications in copy and calculation items of the adapted MMSE (MMSEad) to Portuguese language. The maximum possible score was the same in the two versions: total, 30; copy, 1 and calculation, 5. RESULTS: In the total test score ANOVA detected main effects for education and test, as well as an interaction between these factors: higher schooling individuals performed better than lower schooling ones in both test versions; scores in MMSE-mo were higher than in MMSE-ad in every schooling group. CONCLUSION: Higher schooling levels improve the perfomance in both test versions, the copy and calculation items contributing to this improvement. This might depend on cultural factors. The use of MMSE-mo in illiterate and low school individuals could prevent false positive and false negative cognitive evaluations.


2018 ◽  
Vol 34 (1) ◽  
pp. 34-40 ◽  
Author(s):  
Gizem Ayan ◽  
Ceyda Afacan ◽  
Burc Cagrı Poyraz ◽  
Onur Bilgic ◽  
Suna Avci ◽  
...  

Background: The aim is to validate Turkish version Rowland Universal Dementia Assessment Scale (RUDAS). Methods: One hundred forty patients (>65 years) were included. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition -V was used in all patients. Rowland Universal Dementia Assessment Scale was applied for 2 days. Results were compared with Mini-Mental State Examination; reliability, validity, and statistical values were determined. Results: Time validity was verified. Mini-mental state examination was correlated 45.3% in control and 73% in dementia group. Factor weights varied between 0.44 and 0.81; factor construct was verified as 6-item scoring. When 25 was cutoff point, sensitivity was 92.86% and specificity was 92.86%. Content validity index was found to be 100% by 7 specialists. Cronbach α (0.692) and test–retest reliability (intraclass correlation = 0.987) were determined. Conclusion: Rowland Universal Dementia Assessment Scale (Turkish) is validated and verified as reliable. Test could be applied for 5 minutes approximately; results are not affected by educational status, immigrant status, and language used; however, age and gender have significant effect on results.


2009 ◽  
Vol 92 (2) ◽  
pp. 145-150 ◽  
Author(s):  
A.U. Monsch ◽  
N. S. Foldi ◽  
D. E. Ermini-Fünfschillin ◽  
M. Berres ◽  
K.I. Taylor ◽  
...  

2008 ◽  
Vol 30 (4) ◽  
pp. 346-349 ◽  
Author(s):  
Izabella Dutra de Abreu ◽  
Paula Villela Nunes ◽  
Breno Satler Diniz ◽  
Orestes Vicente Forlenza

OBJECTIVE: To determine the diagnostic accuracy of the Mini-Mental State Examination combined to the Informant Questionnaire on Cognitive Decline in the Elderly for the identification of mild cognitive impairment. METHOD: 191 elderly subjects were assessed with the Mini-Mental State Examination, and their informants were assessed with the Informant Questionnaire on Cognitive Decline in the Elderly. Subjects were divided into three groups according to their cognitive state (controls: n = 67, mild cognitive impairment: n = 65 and dementia: n = 59), which was ascertained by clinical and neuropsychological evaluation. The diagnostic accuracy of each test in the discrimination of diagnostic groups (mild cognitive impairment vs. controls, mild cognitive impairment vs. dementia and dementia vs. controls) was examined with the aid of ROC curves. We additionally verified if the combination of both tests would increase diagnostic accuracy for mild cognitive impairment and control identification. RESULTS: The combination of the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly scores did not increase the Mini-Mental State Examination diagnostic accuracy in the identification of patients with mild cognitive impairment. CONCLUSIONS: The present data do not warrant the combination of the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly as a sufficient diagnostic tool in the diagnostic screening for mild cognitive impairment.


2021 ◽  
Vol 11 ◽  
Author(s):  
Aleksandra A. Szwedo ◽  
Camilla Christina Pedersen ◽  
Anastasia Ushakova ◽  
Lars Forsgren ◽  
Ole-Bjørn Tysnes ◽  
...  

Objectives: To evaluate the impact of SNCA polymorphisms originally identified as risk factors for Parkinson's disease (PD) on the clinical presentation and progression of the disease in a large cohort of population-based patients with incident PD.Methods: Four hundred thirty-three patients and 417 controls from three longitudinal cohorts were included in the study. Disease progression was recorded annually for up to 9 years using the Unified Parkinson's Disease Rating Scale (UPDRS) or Mini-Mental State Examination. Genotypes for five variants within the SNCA locus (rs2870004, rs356182, rs5019538, rs356219, and rs763443) were determined. We studied the association between each variant and disease progression using linear mixed-effects regression models.Results: The clinical profile of the patients with PD at the point of diagnosis was highly uniform between genotype groups. The rs356219-GG genotype was associated with a higher UPDRS II score than A-allele carriers (β = 1.52; 95% confidence interval 0.10–2.95; p = 0.036), but no differences were observed in the rate of progression of the UPDRS II scores. rs356219-GG was also associated with a faster annual change in Mini-Mental State Examination score compared with A-carriers (β = 0.03; 95% confidence interval 0.00–0.06; p = 0.043).Conclusions: We show that the known PD-risk variant rs356219 has a minor effect on modifying disease progression, whereas no differences were associated with rs2870004, rs356182, rs5019538, and rs763443. These findings suggest that SNCA variants associated with PD risk may not be major driving factors to the clinical heterogeneity observed for PD.


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