On the basis of our results, we recommend raising the
RUDAS-Thai cutoff point of 24 of 30 in detecting development
of dementia.
Some limitations were observed in our study. First, the prevalence
and severity of dementia are likely to have more than
expected in the general population which Srinagarind Hospital
is a tertiary care hospital. Second, a misclassification bias could
have occurred which was possible due to study design which
lacked a longitudinal follow-up and brain pathology. Third, the
diagnosis of dementia is primarily a clinical judgment without
the convenience of an easily available biomarker. However, we
excluded the participants with MCI in primary analysis and the
diagnosis of dementia was based on DSM-IV-TR criteria which
are widely used. Fourth, as most participants had 6 years or
lower of education, the results probably better reflects the performance
of the test in this group. Finally, as gender is one of
known risk factors for dementia and there are significantly less
males in the nondementia group, new well-balanced studies in
terms of gender should be performed if possible.