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Tip Sheet 3 - Cognitive Assessment and People From Culturally and Linguistically Diverse (CALD) Background
Tip Sheet 3 - Cognitive Assessment and People From Culturally and Linguistically Diverse (CALD) Background
Tip Sheet 3 - Cognitive Assessment and People From Culturally and Linguistically Diverse (CALD) Background
Benefits of the RUDAS: The RUDAS seems What is the SMMSE: The SMMSE is an
likely to have less cultural and educational adaptation of the Mini Mental State
bias and appears suitable for assessing Examination (MMSE). The MMSE is a
clients from CALD backgrounds. It takes cognitive screening tool that has commonly
approximately 10 minutes to administer. been reported to have cultural and
educational biases (Basic et al, 2009;
Rowland et al, 2006). The SMMSE was
developed by Molloy and Standish in 2007
1
The Assessment of Older People with dementia and depression of Culturally and Linguistically Diverse Backgrounds: A
review of current practice and the development of guidelines for Victorian Aged Care Assessment Services (funded by the
Victorian Department of Health; undertaken by the National Ageing Research Institute, 2011)
to provide a systematic approach to the Culture:
administration of the MMSE. Repeating “no ifs, ands or buts”
Benefits of the SMMSE: The SMMSE has (replaced with a more common
detailed instructions with time limits on phrase/tongue twister).
questions and takes approximately 10 Orientation to time and place (replaced
minutes to administer. with regional names of places or
terminology and accepting traditional
Cut off score: Lower scores indicate greater calendar systems responses; and season
impairment (range: 0-30) removed or replaced with time of day).
Scoring guidelines for assessing cognitive Accepting regional language differences
impairment (Vertesi, Lever, & Molley, in responses.
2001): Education:
Spelling world backward (replaced with
30 = No impairment;
days of the week backwards).
26 – 30 = Considered normal; Counting backward by 7s (replaced with
20 – 25 = Mild; a subtraction task).
Writing a sentence (replaced with tell
10 – 19 = Moderate;
me something about…).
0 – 9 = Severe.
Translated Tools
Things to be aware of
RUDAS
RUDAS:
The RUDAS seems likely to
Although the RUDAS has consistently have less cultural and
been found to be free of cultural and educational bias so it is easily interpreted
educational bias in multicultural samples in by an interpreter during an assessment.
Australia, one study in South India did find Some translated (written) versions are
education impacted on the RUDAS score. available but are not validated.
Sansoni et al (2007) suggest that question 5
(judgement -traffic lights and busy street)
SMMSE
may reflect a degree of acculturation to
dominant Western and urban based There are no formal translations known of
cultures. the SMMSE, however the MMSE has similar
questions to the SMMSE. The MMSE and its
translations are copyrighted by
SMMSE Psychological Assessment Resources (PAR)
Questions most commonly modified in and can be purchased online
overseas studies to make the MMSE more www.parinc.com/.
culturally and linguistically relevant or Some studies which have translated the
relevant to those less educated include: MMSE and provided psychometric
properties are listed in the references
below.
2
The Assessment of Older People with dementia and depression of Culturally and Linguistically Diverse Backgrounds: A
review of current practice and the development of guidelines for Victorian Aged Care Assessment Services (funded by the
Victorian Department of Health; undertaken by the National Ageing Research Institute, 2011)
Further Resources RUDAS References
3
The Assessment of Older People with dementia and depression of Culturally and Linguistically Diverse Backgrounds: A
review of current practice and the development of guidelines for Victorian Aged Care Assessment Services (funded by the
Victorian Department of Health; undertaken by the National Ageing Research Institute, 2011)
Basic, D., Khoo, A., Conforti, D.A., Greek MMSE: Tsolaki, M., V. Iakovidou,
Rowland, J.T., Vrantsidis, F., LoGiudice, et al. (2000c). "Hindi Mental State
D., Hill, K., Harry, J., Lucero, K., Prowse, Examination (HMSE) as a screening test
R.J. (2009) Rowland Universal Dementia for illiterate demented patients."
Assessment Scale, Mini- Mental State EΓKEΦΑΛΟΣ 37: 119-138. Tool available
Examination and General Practitioner in article (in Greek).
Assessment of Cognition in a
multicultural cohort of community-
dwelling older persons with early Italian MMSE: Frisoni, G.B., Rozzini, R.,
dementia. Australian Psychologist, 44, Bianchetti, A., & Trabucchi, M. (1993).
40-53. Principal lifetime occupation and MMSE
score in elderly persons. Journal of
Gerontology, 48(6):S310-4. Note:
Chinese MMSE: Chiu, H. F. K., Lee, H. C., validity data not available.
Chung, W. S., & Kwong, P. K. (1994).
Reliability and validity of the Cantonese
version of Mini-Mental State Vertesi, A., Lever, J. A., Molloy, D.,
Examination – A preliminary Study. The W.Sanderson, B., Tuttle, I., Pokoradi, L.,
Hong Kong Journal of Psychiatry, 4(2), & Principi, E. (2001). Standardized Mini-
25-28. (Tool attached as an appendix in Mental State Examination. Use and
the article, but copyrighted by PAR - interpretation. Canadian Family
education based cut off scores Physician, 47, 2018-2023.
recommended by the authors).
4
The Assessment of Older People with dementia and depression of Culturally and Linguistically Diverse Backgrounds: A
review of current practice and the development of guidelines for Victorian Aged Care Assessment Services (funded by the
Victorian Department of Health; undertaken by the National Ageing Research Institute, 2011)