A pilot study on utility of Malayalam version of Addenbrooke′s Cognitive Examination in detection of amnestic mild cognitive impairment: A critical insight into utility of learning and recall measures

Abstract

Aims:This pilot study sought to determine whether the Malayalam adaptation of Addenbrooke's Cognitive Examination (M-ACE) can effectively identify patients with amnestic mild cognitive impairment (a-MCI) and the impact of measures of learning and free recall.Materials and Methods:A cohort of 23 patients with a-MCI aged between 55-80 years diagnosed as per current criteria and 23 group matched cognitively normal healthy controls (CNHC) were studied. The measures of acquisition and delayed recall were the Rey Auditory Verbal Learning Test (RAVLT) and Wechsler Memory Scale (WMS)-III (verbal and visual subsets) and Delayed Matching-to-sample Test (DMS)-48. Test scores of M-ACE registration and recall scores were included. To examine the differences in test performances between the groups, we compared the number of subjects with test scores less than 1.5 standard deviation (SD) of the control scores. Comparisons between a-MCI and controls were drawn using Fisher's exact test and Mann-Whitney U tests.Results:M-ACE registration component ascertained on a 24-point scale failed to demonstrate any differences between a-MCI and controls (P = 0.665) as opposed to recall judged on a cumulative 10-point scale (P = 0.001). Significant differences were noted in RAVLT list learning (P < 0.001) and list recall (P = 0.003), WMS-III paragraph learning (P <0.001) and recall (P = 0.007), visual learning (P = 0.004) and recall (P = 0.001).Conclusions:M-ACE recall scores are an effective screening tool to identify patients with suspected a-MCI. Both word list and paragraph learning and recall components have been found to be sensitive to concretely identify a-MCI and impairment on at least 2 tests should be considered in the diagnostic criteria of MCI rather than rely on a single screening battery.

Regional Cerebral Blood Flow in the Posterior Cingulate and Precuneus and the Entorhinal Cortical Atrophy Score Differentiate Mild Cognitive Impairment and Dementia Due to Alzheimer Disease

“…Participants with a global cognitive assessment score, as determined on the vernacular version (in the South Indian language of Malayalam of Addenbrooke's Cognitive Examination [ACE-M]), between 88 and 100; a Clinical Dementia Rating score of 0; with formal education of .10 years; no subjective memory symptoms; and with no serious neurologic/psychiatric issues were selected as healthy controls. 18,19 Participants with a Clinical Dementia Rating of ,2 and an ACE-M score between 60 and 78 were confirmed as having AD according to standard National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association diagnostic criteria. 20 Because we wanted to recruit patients with early AD who were largely independent for activities of daily living and capable of giving informed consent, we decided to include subjects with a Clinical Dementia Rating of only 0.5-1.…”

“…21 Exclusion criteria included the presence of a major neurologic disorder (stroke), medical comorbidities (cardiovascular, renal), and psychiatric illness (clinically significant anxiety and depression [Hospital Anxiety Depression Scale score should be ,7], psychosis), similar to those in our previous study. 19…”

Addenbrooke's cognitive examination III: diagnostic utility for mild cognitive impairment and dementia and correlation with standardized neuropsychological tests

“…However, we need cognitive tools that are able to detect neurodegenerative diseases, and especially AD, at earlier stages. Relatively few studies have evaluated the utility of ACE for diagnosing mild cognitive impairment (MCI) (Crawford et al, 2012;Larner and Mitchell, 2014;Menon et al, 2014). The ACE-III total score and scores of its five cognitive domains (attention, memory, language, verbal fluency, and visuospatial abilities) make it potentially useful for detecting neurodegenerative diseases in early stages and establishing a cognitive profile that may aid in differential diagnosis (Matías-Guiu et al, 2016b).…”

Factors predictive of return to work after stroke in patients with mild−moderate disability in India

“…These assessment tools have been found in many studies to be psychometrically sound. HADS has been translated into the local language Malayalam and validated , but the social support questionnaire, although translated, has not been validated in the local language. The HADS consists of seven items for assessment of anxiety and seven for depression, with each item scored from 0 (no problem) to 3 (severe problem).…”