Cognitive Function Test Useful In Cultural and Language Diverse Populations Interview with:
Dr. Raza M. Naqvi, MD, FRCPC
Assistant Professor of Medicine
Division of Geriatric Medicine
Western University
Victoria Hospital London, ON

Medical Research: What is the background for this study? What are the main findings?

Dr. Naqvi: The rates of dementia are rising worldwide. Currently we have over 35 million individuals with dementia in the world and this number will triple to over 100 million by 2050 according to the WHO. Many of these cases are in countries where English is not the first language and thus it is important to ensure that the diagnostic and assessment tools we use are valid in the populations being assessed.

The Rowland Universal Dementia Assessment Scale (RUDAS) was developed in Australia in 2004 specifically to address the challenges of detecting cognitive impairment in culturally and linguistically diverse populations. This assessment tool is a brief questionnaire that clinicians can use as part of their initial assessment in those with memory loss or cognitive decline. It is freely available online (Search ‘RUDAS’) and takes less than 10 minutes for a clinician to complete with the individual being assessed.

Our study was a systematic review and meta-analysis of the RUDAS which aimed to clarify the diagnostic properties of the test and see how it compares to other similar tests that are available.

Through our detailed search of the literature we found 11 studies including over 1200 patients that assessed the RUDAS. The studies showed a combined sensitivity of 77.2% and specificity of 85.9%. This means that a positive test increases one’s likelihood of having dementia more than 5-fold and a negative test decreases their likelihood by 4-fold.

Across the various studies, the Rowland Universal Dementia Assessment Scale performed similarly to the Mini-Mental State Examination (MMSE), the most commonly used cognitive assessment tool worldwide. The RUDAS appeared to be less influenced by language and education than the MMSE.

Medical Research: What should clinicians and patients take away from your report?

Dr. Naqvi: For the clinicians, when performing cognitive assessments on patients, the RUDAS should be considered as an option for aiding in your clinical assessment. It is particularly useful in individuals with cultural and linguistic diversity and may give a more accurate assessment of their cognitive function than traditional tests. It is quick and freely available online.

For patients, ask your clinicians about the tests they are performing and how they will interpret them given your (or your loved one’s) particular background. Ask them whether they have ever tried using the RUDAS and if they would consider using it as an assessment tool if they felt it was appropriate.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Naqvi: The RUDAS has been validated in many countries around the world including Australia, Denmark, Thailand, India, Malaysia, and Iran. It is currently being used in many of these countries and several other European countries as the assessment tool of choice in memory clinics when individuals from diverse backgrounds are being assessed.

Similar validation studies are planned in Canada and should be expanded to other areas of the world where this tool may assist in earlier diagnosis. Diagnosing dementia early is of great importance for planning, providing appropriate medical care, and early treatment (both pharmacological and non-pharmacological).


CMAJ. 2015 Feb 17. pii: cmaj.140802. [Epub ahead of print]

Cognitive assessments in multicultural populations using the Rowland Universal Dementia Assessment Scale: a systematic review and meta-analysis.

Naqvi RM1, Haider S1, Tomlinson G1, Alibhai S1. Interview with: Dr. Raza M. Naqvi, MD, FRCPC (2015). Cognitive Function Test Useful In Cultural and Language Diverse Populations

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Last Updated on March 1, 2015 by Marie Benz MD FAAD