Diagnostic accuracy of the Rowland Universal Dementia Assessment Scale (RUDAS) for the detection of dementia

Abstract Cognitive testing is an important part of dementia assessment. Widely used instruments such as the MMSE and MoCA are limited by language and educational biases. The Rowland Universal Dementia Assessment Scale (RUDAS) was developed to overcome these barriers. We conducted a systematic review and meta-analysis of cross-sectional studies evaluating RUDAS against established diagnostic criteria for all-cause dementia. Case-control designs were excluded to minimise spectrum bias. Sensitivity and specificity estimates were pooled using a bivariate random-effects model. Eleven studies from nine countries were included (n = 3607). In secondary healthcare settings, pooled sensitivity was 84% (95%CI:70–92) and specificity 70% (95%CI:57–80) at the recommended threshold (22/23). Results from community-based studies could not be pooled for a summary measure. Educational levels influenced optimal cut-points. RUDAS demonstrates reasonable diagnostic accuracy but is affected by education. There is an urgent need to develop normative data for use in different settings.