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

Abstract

<b><i>Introduction:</i></b> 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. <b><i>Objective:</i></b> We aimed to validate the m-ACE in Arabic speakers in Egypt with MCI to provide cut-off scores. <b><i>Methods:</i></b> We included 24 patients with MCI and 52 controls and administered the Arabic version of the m-ACE. <b><i>Results:</i></b> There was a statistically significant difference (<i>p</i> < 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 (<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 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). <b><i>Conclusions:</i></b> 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.

Cognitive decline assessment in speakers of understudied languages

“…In another study, native English speakers outperformed non‐native English speakers on several neuropsychological tests, 10 suggesting that delivering tasks in a non‐native language might negatively impact test performance. Similar observations have been reported for many other populations with diverse linguistic abilities, leading to the development of different language‐specific versions of these neuropsychological tests 11–17 . In this context, a plain translation of such tests might not be enough, that is, the transcripted word in another language might have a slightly different conceptual meaning and can bias test results.…”

“…Similar observations have been reported for many other populations with diverse linguistic abilities, leading to the development of different language‐specific versions of these neuropsychological tests. 11 , 12 , 13 , 14 , 15 , 16 , 17 In this context, a plain translation of such tests might not be enough, that is, the transcripted word in another language might have a slightly different conceptual meaning and can bias test results. Thus, administering these translated versions to speakers of understudied languages might pose a real challenge to health‐care professionals to generate clinically useful scores, particularly when the diagnosis is based on comparing measured scores to prior cut‐off values.…”