Validation of the Addenbrooke's Cognitive Examination III in Frontotemporal Dementia and Alzheimer's Disease

Hsieh, Sharpley; Schubert, Samantha; Hoon, Christopher; Mioshi, Eneida; Hodges, John R.

doi:10.1159/000351671

Cited by 757 publications

(743 citation statements)

References 62 publications

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“…As one of the purposes of defining core measures is to make individual studies comparable and meta-analysable, it would be helpful for a future study to formulate an algorithm to be able to compare scores on both the ADAS-Cog and the MMSE and to consider developing algorithms specifically for individual subtypes of dementia. This has recently been accomplished for the ACE-3 (Addenbrooke's Cognitive Examination -third edition) 471 and the MMSE (Professor Gill Livingston, University College London, 4 April 2016, personal communication). This should be possible as a recently published study of the longitudinal cognitive decline of mild to moderate AD participants in placebo arms of 20 trials found the trajectories of the ADAS-Cog and MMSE to be similar.…”

Section: Core Domainsmentioning

confidence: 99%

Development of a core outcome set for disease modification trials in mild to moderate dementia: a systematic review, patient and public consultation and consensus recommendations

Webster

Groskreutz

Grinbergs-Saull

et al. 2017

Health Technol Assess

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Background: There is currently no disease-modifying treatment available to halt or delay the progression of the disease pathology in dementia. An agreed core set of the best-available and most appropriate outcomes for disease modification would facilitate the design of trials and ensure consistency across disease modification trials, as well as making results comparable and meta-analysable in future trials. Objectives: To agree a set of core outcomes for disease modification trials for mild to moderate dementia with the UK dementia research community and patient and public involvement (PPI). Data sources: We included disease modification trials with quantitative outcomes of efficacy from (1) references from related systematic reviews in workstream 1; (2) searches of the Cochrane Dementia and Cognitive Improvement Group study register, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Latin American and Caribbean Health Sciences Literature and PsycINFO on 11 December 2015, and clinical trial registries [International Standard Randomised Controlled Trial Number (ISRCTN) and clinicaltrials.gov] on 22 and 29 January 2016; and (3) hand-searches of reference lists of relevant systematic reviews from database searches. Review methods: The project consisted of four workstreams. (1) We obtained related core outcome sets and work from co-applicants. (2) We systematically reviewed published and ongoing disease modification trials to identify the outcomes used in different domains. We extracted outcomes used in each trial, recording how many used each outcome and with how many participants. We divided outcomes into the domains measured and searched for validation data. (3) We consulted with PPI participants about recommended outcomes. (4) We presented all the synthesised information at a conference attended by the wider body of National Institute for Health Research (NIHR) dementia researchers to reach consensus on a core set of outcomes. Results: We included 149 papers from the 22,918 papers screened, referring to 125 individual trials. Eighty-one outcomes were used across trials, including 72 scales [31 cognitive, 12 activities of daily living (ADLs), 10 global, 16 neuropsychiatric and three quality of life] and nine biological techniques. We consulted with 18 people for PPI. The conference decided that only cognition and biological markers are core measures of disease modification. Cognition should be measured by the Mini Mental State Examination (MMSE) or the Alzheimer’s Disease Assessment Scale – Cognitive subscale (ADAS-Cog), and brain changes through structural magnetic resonance imaging (MRI) in a subset of participants. All other domains are important but not core. We recommend using the Neuropsychiatric Inventory for neuropsychiatric symptoms: the Disability Assessment for Dementia for ADLs, the Dementia Quality of Life Measure for quality of life and the Clinical Dementia Rating scale to measure dementia globally. Limitations: Most of the trials inclu...

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Section: Core Domainsmentioning

confidence: 99%

Development of a core outcome set for disease modification trials in mild to moderate dementia: a systematic review, patient and public consultation and consensus recommendations

Webster

Groskreutz

Grinbergs-Saull

et al. 2017

Health Technol Assess

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“…45 The more comprehensive Addenbrooke's Cognitive Examination III, originally designed as a global screening tool for dementia, tests naming by also asking patients to name 12 pictures. 46 The Boston Naming Test, designed specifically to assess naming by picture confrontation, is a tool widely used by clinicians, as it is easy to administer and score. 47 Initial information gathered about naming performance from these sources (i.e., subjective reports, clinical impression, performance on screening/naming tests) can help the clinician in narrowing the differential diagnoses before requesting further tests, which may include blood chemistry, neuroimaging, neurophysiology, or specialized neuropsychological tests.…”

Section: Clinical Approach To Naming Impairmentsmentioning

confidence: 99%

Neuroanatomical foundations of naming impairments across different neurologic conditions

2015

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The ability to name objects or abstract entities is an essential feature of speech and language, being commonly considered a central component of normal neurologic function. For this reason, the bedside testing of naming performance is part of the neurologic examination, especially since naming impairments can signify the early onset of a progressive disease or the occurrence of a more established problem. Modern neuroscience research suggests that naming relies on specific and distributed networks that operate in concert to support various processing stages, spanning from object recognition to spoken words. Likewise, studies evaluating the types of naming impairments in patients with neurologic conditions have contributed to the understanding of acquired forms of naming impairments and the underlying stages during normal language processing. In this article, we review the neurobiological mechanisms supporting naming, with a focus on the clinical application of these concepts. We provide an overview of the stages of cognitive processing that are hypothesized to support naming. For each stage, we explore the evidence revealing its neural basis, drawing parallels to clinical syndromes that commonly disrupt each stage. We review the patterns of naming impairment across various neurologic conditions, including classic language disorders, such as poststroke aphasia or primary progressive aphasia, as well as other diseases where language impairments may be subtle but helpful for the appropriate diagnosis. In this context, we provide a structured and practical guide for the bedside naming assessments rooted in modern neuroscience, aimed at supporting the evaluation and diagnosis of neurologic conditions that affect language. Neurology ® 2015;85:284-292 GLOSSARY AD 5 Alzheimer disease; AoS 5 apraxia of speech; FTLD 5 frontotemporal lobar degeneration; PCA 5 posterior cortical atrophy; PPA-L 5 logopenic variant of primary progressive aphasia; PPA-S 5 semantic variant of primary progressive aphasia; TLE 5 temporal lobe epilepsy; TOT 5 tip of the tongue.The ability to name objects or abstract entities is essential in everyday speech production. Retrieving the correct word that denotes a specific something relies on an orchestrated sequence of brain processes, ranging from perception of a stimulus to the physical articulation of the sounds used to speak its name. While intimately related, each stage of this complex process relies on the activation of distinct neural circuits. Accordingly, naming impairments may emerge following disruption of one or more of the stages thought to support naming.The process of naming most commonly occurs during discourse, when we are constantly required to retrieve abstract concepts to either understand or deliver a message, or by our need to identify an object perceived in the environment. Thus, naming can relate to an object that was seen, smelled, touched, heard, tasted, or any combination of these modalities. Stimulus processing results in the recognition of the stimulus as a famil...

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“…The comparison group comprised a convenience sample of 55 people aged over 65 who by self-report were healthy with no subjective memory problems or a diagnosis of dementia. Where comparison group participants scored below the threshold score of 82 on the ACE-III (where dementia is detected with 100% specificity, (Hsieh et al 2013)), their data were excluded from analysis. The sample was recruited by advertisement in community groups and snowball sampling.…”

Section: Sample Size Calculationmentioning

confidence: 99%

“…It is a widely used and acceptable measure for people with dementia and is frequently used as a screening tool within memory services. It has been validated against its predecessor the ACE-R and other standardised tests of neuropsychological functioning in early dementia (Hsieh et al 2013), and has been shown to have high internal reliability (Cronbach's α = 0.88 (Velayudhan et al 2014)). …”

Section: Addenbrooke's Cognitive Examination-iiimentioning

confidence: 99%

Impact of Dementia on Mindful Attention: a Cross-Sectional Comparison of People with Dementia and Those Without

Bousfield

Stott

2018

Mindfulness

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Mindfulness-based interventions have been suggested as ways of improving mood and cognition in people with dementia. Existing findings suggest possible benefit from a mindfulness-based group intervention. However, it is unclear whether any structured group activity (rather than mindfulness practice per se) would produce the same benefits, particularly since dementia may impact mindful attention ability. Consequently, we investigated the potential impact of having dementia on mindful attention. We compared the performance of 34 people with dementia recruited from memory services with 55 communityrecruited older people on measures of mindful attention, cognitive flexibility, and cognition, as well as putative nuisance variates of depression, anxiety and premorbid intellectual ability. The groups differed significantly on a range of demographic characteristics and some neuropsychological and mood measures. However, neither the primary prediction (that there would be a large effect size difference between groups, with people with dementia performing significantly more poorly on a measure of mindful attention to the breath), nor the secondary prediction (that performance on this measure would positively correlate with measures of executive function and overall cognition) was supported. We concluded that a diagnosis of dementia may not have a large effect on mindful attention, with consequent implications for future research.

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Validation of the Addenbrooke's Cognitive Examination III in Frontotemporal Dementia and Alzheimer's Disease

Cited by 757 publications

References 62 publications

Development of a core outcome set for disease modification trials in mild to moderate dementia: a systematic review, patient and public consultation and consensus recommendations

Development of a core outcome set for disease modification trials in mild to moderate dementia: a systematic review, patient and public consultation and consensus recommendations

Neuroanatomical foundations of naming impairments across different neurologic conditions

Impact of Dementia on Mindful Attention: a Cross-Sectional Comparison of People with Dementia and Those Without

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