Addenbrooke’s Cognitive Examination-III (ACE-III) test as a new potential tool for screening of cognitive dysfunctions in the course of multiple sclerosis

Abstract

Purpose: Cognitive dysfunction occurs in more than half of patients with multiple sclerosis (MS). The evaluation of the level of cognitive functioning in MS patients is important for the assessment of the disease course and deciding on appropriate therapeutic interventions. The purpose of the study was to analyse the suitability of the Addenbrooke's Cognitive Examination-III (ACE-III) as a screening tool for detecting cognitive dysfunctions in MS. Methods: The study included 28 MS patients and 24 age-and gender-matched controls. The evaluation of cognitive functioning was conducted with ACE-III. The results were subjected to statistical analysis expanded by determining the optimal cutoff points for individual subscales of the test. Results: The level of all cognitive functions was lower in MS patients. Statistically significant differences (p < 0.005) were demonstrated for the results of the ACE-III total score, memory, Mini-ACE (M-ACE) and fluency. The highest AUC values were obtained for total score, memory, MACE and fluency. With the cutoff level of 97 points, the test was characterised by sensitivity of 75% and specificity of over 95%. In terms of memory and fluency, the test was characterised by sensitivity close to 60% and specificity over 90%. Conclusions: The ACE-III presents high diagnostic accuracy, good sensitivity and diagnostic specificity in the assessment of cognitive dysfunctions in MS. The results of the study concerning the deteriorated functioning of MS patients in terms of memory and fluency coincide with the conclusions from the literature and are an attempt to characterise the profile of cognitive dysfunctions in MS patients.

Physical, Cognitive and Social Rehabilitation in Relation to Sleep Quality and Cognitive Functions in the Elderly

“…The Polish instruction does not specify the requirements regarding the time interval between tests. It has a parallel version [ 17 ]. All patients were also assessed for sleep quality using the Athens Insomnia Scale (AIS).…”

“…The Polish instruction does not specify the requirements regarding the time interval between tests. It has a parallel version [ 17 ].…”

Utility of Chinese Versions of Addenbrooke’s Cognitive Examination: A Narrative Review

“…Since then, ACE-III has become the most widely used version, having been translated into more than 33 languages [ 26 ], and it is also considered a good scale for screening cognitive impairment. ACE-III is applied in a wider field of screening cognitive dysfunction in different diseases, including mild cognitive impairment (MCI), AD, FTD, stroke, PD, alcohol-related brain damage, schizophrenia, and so on [ 25 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. The Chinese version of ACE-III was translated in 2012 [ 36 ], and its parallel versions were developed in 2018 and 2019 ( Figure 1 ).…”

“…Similar to ACE-R, aside from detecting early stages of AD, ACE-III has been used for tracking performances of cognitive domains in various neurological disorders [ 25 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ] ( Table 2 ). Memory, rather than other cognitive domains, is more impaired in AD [ 25 ], while fluency and language are more impaired in behavioral variant frontotemporal dementia (bvFTD) and primary progressive aphasia (PPA), respectively [ 25 ].…”

“…The Hungarian ACE-III is able to delineate cognitive decline in PD with all five domains affected [ 31 ]. Memory and fluency domains are impaired in Polish patients with multiple sclerosis (MS), and attention, fluency, language, and visuospatial domains can be affected if there are focal cerebellar lesions [ 30 , 34 ]. Attention, memory, and fluency are impaired in schizophrenia detected by the Thai ACE-III, while memory and visuospatial function are impaired in brain glioma detected by the Malayalam ACE-III [ 29 , 35 ].…”