The Mini-Addenbrooke’s Cognitive Examination (M-ACE) as a brief cognitive screening instrument in Mild Cognitive Impairment and mild Alzheimer’s disease

Miranda, Diane da Costa; Brucki, Sônia Maria Dozzi; Yassuda, Mônica Sanches

doi:10.1590/1980-57642018dn12-040005

Cited by 18 publications

(20 citation statements)

References 24 publications

(19 reference statements)

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“…In addition, although our sample size was not large, it was comparable to other validation studies of the mini-ACE in dementia such as the Brazilian version (dementia = 23 and controls = 25) [20], the Thai version (dementia = 48 and controls = 60) [22] and the Greek version (dementia = 40 and controls = 38) [23]. In addition, our sample size was adequate to provide high sensitivity (92%), high specificity (95%), and high accuracy (94%) for the cutoff score calculated that was comparable to other studies.…”

Section: Discussionsupporting

confidence: 59%

“…Our optimal cutoff point was 18 out of 30, which was lower than the upper cutoff score provided by the English language version of the m-ACE (which was 25) but comparable with the lower cutoff score (which was 21) [4]. Other language versions’ cutoff scores ranged from 16 to 23 out of 30, so our cutoff score of 18 can be considered midrange: 16/30 for the Spanish version (86.7% sensitivity and 87% specificity) [19]; 20/30 for the Brazilian version (95.7% sensitivity and 90.2% specificity) [20]; 21–22/30 for the Chinese version (96% sensitivity and 87% specificity) [21]; 16–17/30 for the Thai version (95.8% sensitivity and 85% specificity) [22]; and 23/30 for the Greek version (97.4% sensitivity and 94.7% specificity) [23].…”

Section: Discussionmentioning

confidence: 86%

“…Possible explanations for the variation between our cutoff score with other language versions of the m-ACE may be due to the type samples investigated in each study with some studies (including ours) using heterogeneous samples that included different types of dementia [4, 19], while others used homogeneous samples (e.g., Alzheimer patients only) [20-22]. In addition, some studies only investigated patients with mild dementia [20, 21], so with less severity of dementia, a better performance might be expected, which can lead to higher cutoff scores. Another explanation for variations in cutoff scores might be differences in education levels between the different samples from different countries.…”

Section: Discussionmentioning

confidence: 99%

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Adaptation and Validation of the Mini-Addenbrooke’s Cognitive Examination in Dementia in Arabic Speakers in Egypt

Qassem

Khater

Emara

et al. 2020

Dement Geriatr Cogn Disord

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Background: The mini-Addenbrooke’s Cognitive Examination (m-ACE) is a brief cognitive battery that assesses 5 subdomains of cognition (attention, memory, verbal fluency, visuospatial abilities, and memory recall). It is scored out of 30 and can be administered in under 5 min providing a quick screening tool for assessment of cognition. Objectives: We aimed to adapt the m-ACE in Arabic speakers in Egypt and to validate it in dementia patients to provide cutoff scores. Methods: We included 37 patients with dementia (Alzheimer’s disease [n = 25], vascular dementia [n = 8], and dementia with Lewy body [n = 4]) and 43 controls. Results: There was a statistically significant difference (p < 0.001) on the total m-ACE score between dementia patients (mean 10.54 and standard deviation [SD] 5.83) and controls (mean 24.02 and SD 2.75). There was also a statistically significant difference between dementia patients and controls on all sub-score domains of the m-ACE (p < 0.05). Performance on the m-ACE significantly correlated with both the Mini-Mental State Examination (MMSE) and the Addenbrooke’s Cognitive Examination-III (ACE-III). Using a receiver operator characteristic curve, the optimal cutoff score for dementia on the m-ACE total score was found to be 18 (92% sensitivity, 95% specificity, and 94% accuracy). Conclusions: We adapted the m-ACE in Arabic speakers in Egypt and provided objective validation of it as a screening tool for dementia, with high sensitivity, specificity, and accuracy.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

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Adaptation and Validation of the Mini-Addenbrooke’s Cognitive Examination in Dementia in Arabic Speakers in Egypt

Qassem

Khater

Emara

et al. 2020

Dement Geriatr Cogn Disord

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“…Our optimal cut-off point was 21 out of 30, with comparable sensitivity and specificity to other language versions: 21–22 out of 30 for the Thai version (95% sensitivity and 85% specificity) [8], 25–26 out of 30 for the Chinese version (88% sensitivity and 72% specificity) [9], 25–26 out of 30 for the Japanese version (77% sensitivity and 72% specificity) [10], and 27 out of 30 for the Brazilian version (75% sensitivity and 60% specificity) [11]. A possible explanation for variations in cut-off scores might be differences in education levels between the different samples from different countries.…”

Section: Discussionmentioning

confidence: 99%

“…The m-ACE was found to be superior to the Mini-Mental State Examination (MMSE) in diagnostic utility [5] and has been translated into several languages [6-12], including Arabic [13]. It has also been validated in MCI in several populations [8-11] but not in Arabic speakers.…”

Section: Introductionmentioning

confidence: 99%

Validation of the Mini-Addenbrooke’s Cognitive Examination in Mild Cognitive Impairment in Arabic Speakers

Qassem

Khater

Emara

et al. 2021

Dement Geriatr Cogn Disord

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Introduction: Mild cognitive impairment (MCI) represents a target for early detection and intervention in dementia, yet there is a shortage of validated screening tools in Arabic to diagnose MCI. The mini-Addenbrooke’s Cognitive Examination (m-ACE) is a brief cognitive battery that is scored out of 30 and can be administered in under 5 min providing a quick screening tool for assessment of cognition. Objective: We aimed to validate the m-ACE in Arabic speakers in Egypt with MCI to provide cut-off scores. Methods: We included 24 patients with MCI and 52 controls and administered the Arabic version of the m-ACE. Results: There was a statistically significant difference (p < 0.0001) on the total m-ACE score between MCI patients (mean 18.54, SD 3.05) and controls (mean 24.54, SD 2.68). There was also a statistically significant difference between MCI patients and controls on the total score and the fluency, visuospatial, and memory recall sub-scores of the m-ACE (p < 0.05). Performance on the m-ACE significantly correlated with both the Mini-Mental State Examination (MMSE) and the Addenbrooke’s Cognitive Examination-III (ACE-III). Using a receiver operator characteristic curve, the optimal cut-off score for MCI on the m-ACE total score was 21 out of 30 (87.5% sensitivity, 84.6% specificity, and 85.5% accuracy). Conclusions: We validated the Arabic m-ACE in Egyptian patients with MCI and provided objective validation of it as a screening tool for MCI, with good sensitivity, specificity, and accuracy that is comparable to other translated versions of the m-ACE in MCI.

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Validation of a modified Chinese version of Mini‐Addenbrooke's Cognitive Examination for detecting mild cognitive impairment

Pan

Cui

et al. 2021

Brain and Behavior

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Background: For detecting mild cognitive impairment (MCI), brief cognitive screening tools are increasingly required for the advantage of time saving and no need for special equipment or trained raters. We aimed to develop a modified Chinese version of Mini-Addenbrooke's Cognitive Examination (C-MACE) and further evaluate its validation in detecting MCI. Methods: A total of 716 individuals aged from 50 to 90 years old were recruited, including 431 cognitively normal controls (NC) and 285 individuals with MCI. The effect size of Cramer's V was used to explore which items in the Chinese version of Addenbrooke's Cognitive Examination-III (ACE-III-CV) best associated with MCI and to form the C-MACE. Receiver operating characteristic (ROC) analyses were carried out to explore the ability of C-MACE, ACE-III-CV, Chinese version of Montreal Cognitive Assessment-Basic (MoCA-BC), and Mini-Mental State Examination (MMSE) in discriminating MCI from NC. Results: Five items with greatest effect sizes of Cramer's V were selected from ACE-III-CV to form the C-MACE: Memory Immediate Recall, Memory Delayed Recall, Memory Recognition, Verbal Fluency Animal and Language Naming. With a total score of 38, the C-MACE had a satisfactory classification accuracy in detecting MCI (area under the ROC curve, AUC = 0.892), superior to MMSE (AUC = 0.782) and comparable to ACE-III-CV (AUC = 0.901) and MoCA-BC (AUC = 0.916). In the subgroup of Age > 70 years, Education ≤ 12 years, the C-MACE got a highest classification accuracy (AUC = 0.958) for detecting MCI. Conclusion: In the Chinese-speaking population, C-MACE derived from ACE-III-CV may identify MCI with a good classification accuracy, especially in aged people with low education.

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The Mini-Addenbrooke’s Cognitive Examination (M-ACE) as a brief cognitive screening instrument in Mild Cognitive Impairment and mild Alzheimer’s disease

Cited by 18 publications

References 24 publications

Adaptation and Validation of the Mini-Addenbrooke’s Cognitive Examination in Dementia in Arabic Speakers in Egypt

Adaptation and Validation of the Mini-Addenbrooke’s Cognitive Examination in Dementia in Arabic Speakers in Egypt

Validation of the Mini-Addenbrooke’s Cognitive Examination in Mild Cognitive Impairment in Arabic Speakers

Validation of a modified Chinese version of Mini‐Addenbrooke's Cognitive Examination for detecting mild cognitive impairment

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