Predictors of the Rowland Universal Dementia Assessment Scale (RUDAS) Performance in Adults with Sickle Cell Disease

Background: Sickle cell disease (SCD) patients are at significant risk for stroke and silent cerebral infarcts. At least 33% of adults have cognitive dysfunction. However, access to specialized assessments is limited, and there is currently an unmet need for a fast, easy to administer, screening tool for cognitive impairment in SCD. The Rowland Universal Dementia Assessment Scale (RUDAS) is a 6-item task-based questionnaire that evaluates executive function, memory, language, visual-spatial function, praxis and judgment. It has been validated in many cultures and neurocognitive diseases other than SCD. Hypothesis: Poor RUDAS performance is associated with the presence of SCD complications independent of age, socioeconomic and education factors. Methods: Study design: cross-sectional, two adult sickle cell comprehensive care centers in Canada. Inclusion criteria: out-patients ≥18 years-old; all SCD phenotypes. Exclusion criteria: inability to obtain informed consent and/or follow study instructions. Intervention: RUDAS was administered twice, 2-4 months apart, in French or English, based on the patient's preference. Survey on demographics and patient-reported outcomes (PROMIS® tools for Depression and Anxiety) were completed. Baseline characteristics, SCD complications, and laboratory results were collected. Statistical plan: t-tests, Fisher exact and chi-squared tests, for continuous and discrete variables respectively, were performed to identify possible association between RUDAS and biologic, socioeconomic, and cultural factors, SCD related complications, comorbid conditions, laboratory parameters, and use of disease-modifying therapy (Table). Associations with univariate P