Adaption and preliminary validation of the Addenbrooke's Cognitive Examination‐III as a screening test for mild cognitive impairment and dementia in hearing‐impaired individuals

Abstract

Background A large proportion of older adults assessed for cognitive impairment likely have hearing loss, potentially affecting accuracy of cognitive performance estimations. This study aimed to develop a hearing‐impaired version of the Addenbrooke's Cognitive Examination‐III (HI‐ACE‐III) and to assess whether the HI‐ACE‐III can accurately distinguish people with mild cognitive impairment (MCI) and dementia from cognitively intact controls. Methods The HI‐ACE‐III was developed by converting verbal instructions into a visual, timed PowerPoint presentation. Seventy‐four participants over the age of 60 years were classified into three groups: 29 had MCI, 15 had mild to moderate dementia and 30 were cognitively intact controls. Receiver operating characteristic (ROC) curves were graphed to test screening accuracy. Concurrent validity was examined through correlations between HI‐ACE‐III domain scores and relevant, visually presented standardized neuropsychological measures. Results ROC analysis for dementia revealed an area under the curve (AUC) of 0.99, achieving excellent sensitivity (100%) and good specificity (93.3%) at an optimum cut‐off of <87. The AUC for MCI was 0.86, achieving reasonable sensitivity (75.9%) and good specificity (86.7%) at an optimum cut‐off of <92. HI‐ACE‐III subtests shared anticipated and statistically significant correlations with established measures of cognitive functioning. Internal consistency of the HI‐ACE‐III was excellent as verified with Cronbach's alpha (α = 0.904). Conclusions Preliminarily, the HI‐ACE‐III showed good reliability, validity and screening utility for MCI and dementia in older adults in a hearing‐impairment context. The adapted HI‐ACE‐III may offer accurate and reliable indication of cognitive performance, supporting timely diagnosis and research examining links between hearing loss and cognitive decline.

Resting EEG power spectra across middle to late life: associations with age, cognition, APOE-ɛ4 carriage, and cardiometabolic burden

“…Therefore, the total number of participants included in these analyses was 86 (51 female, age range 50-80; mean age 65.5 ± 7.7 years). Over half (55%) of participants were classified as having MCI or dementia according to the cut-off of ≤92 on the ACE-III (North et al 2021). ACE-III scores ranged between 72 and 99, with a mean of 91.3 (SD=5.3).…”

Resting EEG power spectra across middle to late life: Associations with age, cognition, APOE-ε4 carriage and cardiometabolic burden

“…These exclusion judgments were made prior to data analysis. Over half (55%) of participants scored below the 92 ACE-III MCI cut-off (North et al 2021), although no participants had a formal MCI diagnosis. ACE-III scores ranged between 72 and 99, with a mean of 91.3 (SD=5.3).…”

Evaluating the impact of COVID-19 on vertigo and hearing impairment: A post-recovery analysis

“…The high mean SDS of 94.6 suggests excellent speech understanding among participants. [32] Additionally, most participants had Type A tympanograms, indicating normal middle ear function. [7] These findings are reassuring and suggest that the majority of COVID-19 survivors in our cohort did not experience significant hearing loss or middle ear dysfunction.…”