<p>Hindi Version of Addenbrooke’s Cognitive Examination III: Distinguishing Cognitive Impairment Among Older Indians at the Lower Cut-Offs</p>

Abstract

Background: Screening and diagnostic tests provide an objective measure of cognitive performance and also aid in distinguishing mild cognitive impairment (MCI) from major neurocognitive disorder (MNCD). Further, when such tests are culturally and educationally unbiased, it strengthens their diagnostic utility. This study aimed to validate the Hindi version of Addenbrooke's Cognitive Examination III (ACE-III) in Indian older adults and compare its validity with the Hindi Mini-Mental State Examination (HMSE). Methods: A sample of 412 consenting older adults visiting a memory clinic was recruited into the study. They were categorized into three groups: healthy controls (n=222), MCI (n=70), and MNCD (n=120). The complete clinical protocol was followed. Hindi ACE-III and HMSE were administered and were statistically analyzed. Results: The optimal cutoff values to detect MCI and MNCD with ACE-III were 71 and 62 (AUC: 0.849 and 0.884), respectively, which were slightly higher than with HMSE (AUC: 0.822, 0.861). Education-and age-stratified cutoffs were also computed. Conclusion: Hindi ACE-III has good discriminating power at lower cutoffs than the standard scores in differentiating between MCI and MNCD.

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

“…Compared to the previous validation of the Arabic ACE-III in dementia, sensitivity and specificity for the optimal cut-off in MCI were lower (75% sensitivity and 82% specificity) compared to dementia (89% sensitivity and 95% specificity) [21]. This was the case with all the other language versions of the ACE-III that generally showed lower sensitivity and specificity when validated in MCI patients than in dementia subjects [6-12]. This could be explained by the fact that most of the cognitive screening tools (including the ACE-III) were originally designed for the diagnosis of established dementia, and not for its prodrome or for milder forms of cognitive impairment.…”

“…The original validation study of the English-language version of ACE-III did not investigate MCI [4]. Validations of the ACE-III in other languages in MCI revealed comparable optimal cut-off scores to our study: 75/76 for the Thai-language version [11], 73/74 for the Spanish-language version [10], 82 for the Portuguese-language version [9], 88/89 for the Japanese-language version [8], 77/78 for the Malay-language version [6], 88/89 for the Chinese-language version [7], and 71 for the Hindi-language version [12]. A possible explanation for why our sample had a lower cut-off score than the Japanese and Chinese versions might be due to differences in education levels.…”

“…It has been translated into 25 languages, including Arabic, and has primarily been validated in patients with dementia [5]. It has also been validated in MCI in several populations [6-12] but not in Arabic speakers.…”

Psychometric properties of Addenbrooke’s Cognitive Examination III (ACE-III): An item response theory approach

“…It provides information from five cognitive domains (attention, memory, language, verbal fluency, and visuospatial abilities), which makes it an excellent alternative to obtain a deterioration profile [43]. Despite several studies evaluating the validity of ACE-III and its adaptation to a large number of languages and cultural contexts [44], most of these studies focus on analyzing its diagnostic utility and its relation to other tests or variables [45][46][47][48][49][50][51][52][53][54]. At present, few studies have conducted a psychometric analysis of ACE-III from parametric IRT approaches [55].…”

Uso da Addenbrooke&#39;s Cognitive Examination III (ACE-III) em pacientes com doença de Parkinson idiopática

“…Foram encontradas diferenças significantes nos escores totais da ACE-III entre pacientes com doença de Alzheimer e controles (p < 0,05) e entre pacientes com doença de Alzheimer e DFT-vc (p < 0,05). Com um ponto de corte de 86, 98,6% dos pacientes com DA, 83,9% dos pacientes com demência frontotemporal variante comportamental e 84,2% dos controles foram classificados corretamente.Um estudo, realizado na Índia(Bajpai et al, 2020), o qual objetivou validar o Exame Cognitivo de Addenbrooke (ACE-III) em idosos indianos e comparar a sua validade diagnóstica com o MEEM. Para isso foram recrutados 412 idosos, III foi também padronizada para uso em sete idiomas, na Índia(Mekala et al, 2020).…”