Chaaya M, Phung T K T, El Asmar K, Atweh S, Ghusn H, Khoury R M, Prince M, Nielsen T R, Waldemar G
a Department of Epidemiology and Population Health, Faculty of Health Sciences , American University of Beirut , Beirut , Lebanon.
b Department of Neurology, Danish Dementia Research Center, The Neuroscience Center , University of Copenhagen , Copenhagen , Denmark.
Aging Ment Health. 2016 Aug;20(8):880-7. doi: 10.1080/13607863.2015.1043620. Epub 2015 May 18.
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.
目前缺乏经过验证的阿拉伯语痴呆筛查测试。鉴于中东和北非地区老年人的教育水平较低，常用的筛查工具——简易精神状态检查表并不十分适用。而罗兰通用痴呆评估量表（RUDAS）则是专门设计用于尽量减少文化学习和教育的影响。本研究的目的是验证阿拉伯语版的RUDAS（A-RUDAS），评估其筛查轻度和中度痴呆的能力，并评估教育、性别、年龄、抑郁和招募地点对其性能的影响。
对从社区、社区基层医疗诊所和医院专科诊所招募的232名65岁及以上的老年人进行A-RUDAS测试。其中，136人认知正常，96人患有痴呆症。临床医生根据《精神疾病诊断与统计手册》第四版（DSM-IV）标准诊断痴呆症。对参与者认知状态不知情的访谈者进行A-RUDAS测试。针对三个临界值检查了A-RUDAS的心理测量特性。
在临界值≤22时，A-RUDAS表现出良好的敏感性（83%）和特异性（85%），受试者工作特征曲线下面积为83.95%。在对年龄、性别、教育、抑郁和招募地点进行调整后，A-RUDAS评分在针对DSM-IV诊断筛查轻度和中度痴呆方面显示出较高的准确性。
建议在临床实践和针对讲阿拉伯语人群的研究中使用A-RUDAS进行痴呆筛查，最佳临界值为≤22。
