Comparison of the Rowland University Dementia Assessment Scale and Mini-Mental State Examination cognitive screening tools among older people in Nigeria

Abstract

Introduction and objectives: Dementia is progressive neuro-degeneration characterized by ongoing deterioration in cognition and capacity for independent living. Empirical evidence is lacking on the best screening tool because of the cultural and linguistic diversities of Nigerians. This study screened for dementia and described the differences between the Rowland University Dementia Assessment Scale (RUDAS) and Mini-Mental State Examination (MMSE) tools among older people at the University College Hospital (UCH), Ibadan, Nigeria. Materials and Methods: Cross-sectional hospital-based descriptive study of 96 older people ≥60years at UCH, Ibadan. Dementia was assessed with the RUDAS and MMSE tools. Socio-demographic characteristics and memory issues were also assessed. Descriptive and inferential statistics were done and the level of significance was set at 5%. Results: The mean age was 70.5±7.4 years and 57(59.4%) were female respondents. The overall mean score on RUDAS was 22.8±4.0 points and MMSE was 24.2±4.8 points. Point prevalence of dementia on RUDAS and MMSE were 6.2% and 4.2% respectively. Using MMSE as the standard, the AUROC for the RUDAS was 85.9% (95% CI:60.4-99.8), and its sensitivity and specificity were75.0% and 96.7% respectively. Both RUDAS and MMSE were associated with age and residence. MMSE, but not the RUDAS, scores were influenced by total years of education (p<0.001). Conclusion: RUDAS was as accurate as MMSE for the screening of dementia in our setting. Contrary to the MMSE, RUDAS was not influenced by the years of education for dementia. Our finding supports the use of RUDAS as an effective alternative test to MMSE for dementia screening in older Nigerians.