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

Abstract

<b><i>Background:</i></b> 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. <b><i>Objectives:</i></b> We aimed to adapt the m-ACE in Arabic speakers in Egypt and to validate it in dementia patients to provide cutoff scores. <b><i>Methods:</i></b> We included 37 patients with dementia (Alzheimer’s disease [<i>n</i> = 25], vascular dementia [<i>n</i> = 8], and dementia with Lewy body [<i>n</i> = 4]) and 43 controls. <b><i>Results:</i></b> There was a statistically significant difference (<i>p</i> < 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 (<i>p</i> < 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). <b><i>Conclusions:</i></b> 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.

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

“…Compared to the sensitivity and specificity of the Arabic m-ACE in dementia (92% sensitivity and 95% specificity) [13], those in MCI were lower (87.5% sensitivity and 84.6% specificity). Most cognitive screening tools (including the m-ACE) were not originally designed to specifically diagnose MCI but to diagnose more global cognitive impairments such as dementia.…”

“…Mini-Addenbrooke’s Cognitive Examination (m-ACE) [3] is a shorter version of the ACE-III used as a quick screening tool to assess cognition. In our study, we used the Arabic version of the m-ACE [13].…”

“…It was derived from the longer ACE-III that normally takes about 15–20 min to complete [4], so the m-ACE is more suited for busy clinical settings. 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.…”

“…Previously, the Arabic version of the m-ACE was validated in patients with dementia in Egypt [13] establishing optimal cut-offs for this population. Therefore, the aim of this study was to validate and provide cut-off scores for the Arabic version of the m-ACE in a sample of older Egyptian subjects with MCI to make available a single validated quick screening tool for both dementia and MCI that can be used in daily clinical practice.…”

Mini-ACE: Validation Study Among Older People in Long-Term Care

“…The M-ACE has been translated and validated in several languages, with validation studies conducted in various countries, such as Thailand (Charernboon, 2019), Poland (Kaczmarek et al, 2022), Greece (Kourtesis et al, 2020), the United Kingdom (Larner, 2019), Hungary (Lucza et al, 2018), Brazil (Miranda et al, 2018), China (Pan et al, 2022), Egypt (Qassem et al, 2021), and Japan (Senda et al, 2020). The Portuguese version of the M-ACE, which was extracted from the ACE-III, has also been validated and shown good psychometric properties (Peixoto et al, 2019).…”