Sensitivity of the Mini-Mental State Examination, Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination III to everyday activity impairments in dementia: an exploratory study

Giebel, Clarissa; Challis, David

doi:10.1002/gps.4570

Cited by 31 publications

(27 citation statements)

References 41 publications

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“…In a more recent study, a longer time spent on TMT B was associated with a lower score on the A-IADL-Q, and a model incorporating DSB indicated a satisfactory fit when testing the relationship between change in IADL and change in memory functioning (Koster et al, 2015). There are limited studies exploring the relationship between the ACE III and IADL measures; research that has been done suggests that the ACE III is sensitive to everyday functioning (Giebel and Challis, 2017;Hsieh et al, 2013;Scally, 2016), but this is based on small sample sizes. In a more recent study, the ACE III was related to functional impairment across a number of dementia syndromes (So et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Enhancing ‘meaningfulness’ of functional assessments: UK adaptation of the Amsterdam IADL questionnaire

Stringer

Leroi

Sikkes

et al. 2020

Int. Psychogeriatr.

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Objective: Commonly used measures of instrumental activities of daily living (IADL) do not capture activities for a technologically advancing society. This study aimed to adapt the proxy/informant-based Amsterdam IADL Questionnaire (A-IADL-Q) for use in the UK and develop a self-report version.Design: An iterative mixed method cross-cultural adaptation of the A-IADL-Q and the development of a self-report version involving a three-step design: (1) interviews and focus groups with lay and professional stakeholders to assess face and content validity; (2) a questionnaire to measure item relevance to older adults in the U.K.; (3) a pilot of the adapted questionnaire in people with cognitive impairment.Setting: Community settings in the UK.Participants: One hundred and forty-eight participants took part across the three steps: (1) 14 dementia professionals; 8 people with subjective cognitive decline (SCD), mild cognitive impairment (MCI), or dementia due to Alzheimer's disease; and 6 relatives of people with MCI or dementia; (2) 92 older adults without cognitive impairment; and (3) 28 people with SCD or MCI. Measurements:The cultural relevance and applicability of the A-IADL-Q scale items were assessed using a 6-point Likert scale. Cognitive and functional performance was measured using a battery of cognitive and functional measures.Results: Iterative modifications to the scale resulted in a 55-item adapted version appropriate for UK use (A-IADL-Q-UK). Pilot data revealed that the new and revised items performed well. Four new items correlated with the weighted average score ). An exploratory analysis of convergent validity found correlations in the expected direction with cognitive and functional measures. Conclusion:The A-IADL-Q-UK provides a measurement of functional decline for use in the UK that captures culturally relevant activities. A new self-report version has been developed and is ready for testing. Further evaluation of the A-IADL-Q-UK for construct validity is now needed.

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Section: Discussionmentioning

confidence: 99%

Enhancing ‘meaningfulness’ of functional assessments: UK adaptation of the Amsterdam IADL questionnaire

Stringer

Leroi

Sikkes

et al. 2020

Int. Psychogeriatr.

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“…In primary care, Holsinger et al [13] compared the modified MMSE, MIS, and Mini-Cog in the diagnosis of dementia, obtaining better results with the modified MMSE and Mini-Cog, while the MMSE achieved higher specificity but lower sensitivity. Recently, Giebel and Challis [14] obtained greater sensitivity to detect everyday functioning impairment in mild-to-moderate dementia with the ACE-III in comparison to the MoCA and MMSE in a cohort of 39 patients with dementia. Our aim was to evaluate and compare the diagnostic properties of 5 widely used screening tests (MMSE, ACE-III, MIS, MoCA, and RUDAS) for the diagnosis of mild dementia of Alzheimer's type.…”

Section: Introductionmentioning

confidence: 99%

Comparative Diagnostic Accuracy of the ACE-III, MIS, MMSE, MoCA, and RUDAS for Screening of Alzheimer Disease

Matías‐Guiu

Valles‐Salgado²,

Rognoni³

et al. 2017

Dement Geriatr Cogn Disord

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Background: Our aim was to evaluate and compare the diagnostic properties of 5 screening tests for the diagnosis of mild Alzheimer disease (AD). Methods: We conducted a prospective and cross-sectional study of 92 patients with mild AD and of 68 healthy controls from our Department of Neurology. The diagnostic properties of the following tests were compared: Mini-Mental State Examination (MMSE), Addenbrooke's Cognitive Examination III (ACE-III), Memory Impairment Screen (MIS), Montreal Cognitive Assessment (MoCA), and Rowland Universal Dementia Assessment Scale (RUDAS). Results: All tests yielded high diagnostic accuracy, with the ACE-III achieving the best diagnostic properties. The area under the curve was 0.897 for the ACE-III, 0.889 for the RUDAS, 0.874 for the MMSE, 0.866 for the MIS, and 0.856 for the MoCA. The Mini-ACE score from the ACE-III showed the highest diagnostic capacity (area under the curve 0.939). Memory scores of the ACE-III and of the RUDAS showed a better diagnostic accuracy than those of the MMSE and of the MoCA. All tests, especially the ACE-III, conveyed a higher diagnostic accuracy in patients with full primary education than in the less educated group. Implementing normative data improved the diagnostic accuracy of the ACE-III but not that of the other tests. Conclusions: The ACE-III achieved the highest diagnostic accuracy. This better discrimination was more evident in the more educated group.

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“…The ACE-R test is also treated by clinicians as an extension of cognitive performance assessment when the results of shorter tests are inconclusive [7]. In addition, the ACE-III test is considered the most sensitive tool for assessing daily functioning of a patient, and especially the subscale for the assessment of language skills as significantly related to the initiation of activity by the patient [8]. The results obtained in the presented study with the ACE-III revealed lower levels of all cognitive functions in the group of patients with MS. Statistically significant differences (p < 0.05) were demonstrated for the results of the ACE-III total score, memory, M-ACE and verbal fluency.…”

Section: Discussionmentioning

confidence: 99%

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

Figlus¹,

Obrembska²,

Miller³

et al. 2018

ppn

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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.

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Sensitivity of the Mini-Mental State Examination, Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination III to everyday activity impairments in dementia: an exploratory study

Cited by 31 publications

References 41 publications

Enhancing ‘meaningfulness’ of functional assessments: UK adaptation of the Amsterdam IADL questionnaire

Enhancing ‘meaningfulness’ of functional assessments: UK adaptation of the Amsterdam IADL questionnaire

Comparative Diagnostic Accuracy of the ACE-III, MIS, MMSE, MoCA, and RUDAS for Screening of Alzheimer Disease

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

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