Validation of the German Revised Addenbrooke’s Cognitive Examination for Detecting Mild Cognitive Impairment, Mild Dementia in Alzheimer’s Disease and Frontotemporal Lobar Degeneration

Abstract

Background/Aims: The diagnostic accuracy of the German version of the revised Addenbrooke’s Cognitive Examination (ACE-R) in identifying mild cognitive impairment (MCI), mild dementia in Alzheimer’s disease (AD) and mild dementia in frontotemporal lobar degeneration (FTLD) in comparison with the conventional Mini Mental State Examination (MMSE) was assessed. Methods: The study encompasses 76 cognitively healthy elderly individuals, 75 patients with MCI, 56 with AD and 22 with FTLD. ACE-R and MMSE were validated against an expert diagnosis based on a comprehensive diagnostic procedure. Statistical analysis was performed using the receiver operating characteristic method and regression analyses. Results: The optimal cut-off score for the ACE-R for detecting MCI, AD, and FTLD was 86/87, 82/83 and 83/84, respectively. ACE-R was superior to MMSE only in the detection of patients with FTLD [area under the curve (AUC): 0.97 vs. 0.92], whilst the accuracy of the two instruments did not differ in identifying MCI and AD. The ratio of the scores of the memory ACE-R subtest to verbal fluency subtest contributed significantly to the discrimination between AD and FTLD (optimal cut-off score: 2.30/2.31, AUC: 0.77), whereas the MMSE and ACE-R total scores did not. Conclusion: The German ACE-R is superior to the most commonly employed MMSE in detecting mild dementia in FTLD and in the differential diagnosis between AD and FTLD. Thus it might serve as a valuable instrument as part of a comprehensive diagnostic workup in specialist centres/clinics contributing to the diagnosis and differential diagnosis of the cause of dementia.

The Addenbrooke's Cognitive Examination Revised as a potential screening test for elderly drivers

“…Driving impairments might be expected in various populations, as normal aging, clinical neurologic disease (namely, Alzheimer's Disease, Parkinson's Disease, Multiple Sclerosis, Stroke) and psychiatric conditions (namely, Major Depression, Schizophrenia) that affect a person's cognitive functioning and may impact driving ability (Marcotte and Scott, 2009). ACE-R research has examined these conditions (e.g., Alexopoulos et al, 2010;Dudas et al, 2005;Hamilton et al, 2009;Kwak et al, 2010;Mathew et al, 2011;Pendlebury et al, 2012;Reyes et al, 2009).…”

“…There are a number of reasons to analyse this brief cognitive test in relation to on-road driving performance. Firstly, it is a more accurate means of detecting early cognitive dysfunction than the MMSE, with a number of added items to increase its sensitivity to specific dementing diseases (e.g., Alexopoulos et al, 2010;Mioshi et al, 2006;Simões et al, 2011;Torralva et al, 2011;Yoshida et al, 2012) that might adversely affect driving abilities and increase crash risk (Iverson et al, 2010). Secondly, it comprises an MMSE score and sub-scores in five cognitive domains, which could provide qualitative and discriminative data regarding the patient's driving-related cognitive profile.…”

Utility and Limitations of Addenbrooke’s Cognitive Examination-Revised for Detecting Mild Cognitive Impairment in Parkinson’s Disease

“…Using a cutoff score of 88 out of 100, the ACE-R has been shown to detect dementia in other neurodegenerative diseases with high sensitivity and specificity (94 and 89%, respectively) [41]. Whilst the ACE-R has also been shown to be useful in detecting MCI in a range of conditions [41,42], to our knowledge, no study has explored the utility of the ACE-R in detecting PD-MCI. Therefore, this study sought to investigate the ability of the ACE-R to accurately determine PD-MCI and to assess factors that may influence its diagnostic capabilities.…”

Validation of the Russian version of the modified Addenbrooke’s cognitive examination for Alzheimer’s disease diagnosis

“…В исследованиях по валидизации АКШ-м на других языках пороговое значение для диагно-стики деменции по данным АКШ-м варьировало от 79 до 85 баллов [3][4][5][6][7][8][9]. Самый высокий балл (88) был получен в оригинальных исследованиях АКШ и АКШ-м [10,11].…”

“…АКШ была валидизирована на нескольких язы-ках, включая индийский [4], французский [5], ис-панский [6], немецкий [7], датский [8], итальянский [9] и японский [10]. АКШ имеет более высокие чув-ствительность и специфичность, чем MMSE, при диагностике ранних стадий деменции.…”