Validation of the Addenbrooke’s Cognitive Examination for Detecting Early Alzheimer’s Disease and Mild Vascular Dementia in a German Population

Abstract

We assessed the diagnostic accuracy of the German version of the Addenbrooke’s Cognitive Examination (ACE) in identifying early Alzheimer’s disease (AD) and mild vascular dementia (VaD) in comparison with the conventional Mini-Mental State Examination (MMSE). The study refers to 50 patients with mild dementia of AD, 26 patients with mild dementia of vascular etiology and to 54 cognitively normal subjects. The ACE and MMSE were validated against an expert diagnosis based on a comprehensive diagnostic workup. Statistical analysis was performed using the receiver operator characteristics method. The optimal cut-off score for the ACE for detecting dementia in patients with early AD was 85/86, which had a sensitivity of 93% and a specificity of 86%. The optimal cut-off for the ACE for the identification of dementia in patients with mild VaD was also 85/86 and it had a sensitivity of 93% and a specificity of 100%. The ĸ values imply a substantial agreement between the diagnoses made by the ACE and the MMSE. The German version of the ACE is a short and practical but accurate test battery for the identification of AD and VaD, assessing a broad range of cognitive functions and providing a wide profile of cognitive functions/dysfunctions.

Validation of the Chinese Version of Addenbrooke's Cognitive Examination-Revised for Screening Mild Alzheimer's Disease and Mild Cognitive Impairment

“…Second, the Chinese ACE-R has not been validated in other dementia syndromes. Prior studies observed that ACE-R could be applied as a differentiating tool between frontotemporal dementia and AD [9], AD and subcortical ischemic vascular dementia [32,33], and AD and vascular dementia [19]. Third, considering the invasion and the economic cost, we were not able to reveal the relationship between neuropsychological assessments and other biomarkers, such as Aβ 42 or tau of cerebrospinal fluid, and positive positron emission tomography amyloid imaging in three different stages (preclinical AD, MCI due to AD, and dementia due to AD) according to the new diagnostic criteria of AD, published by the National Institute on Aging and the Alzheimer's Association work group in 2011 [34].…”

“…Addenbrooke's Cognitive Examination-Revised (ACE-R) is a brief cognitive test revised by Mioshi et al [9] in 2006, and, by contrast, recent series of studies recommended ACE-R as a superior tool for screening for early dementia and a-MCI in normal populations as well as for discriminating different types of dementias [10,11]. At present, ACE-R has been translated into many languages and has been validated in different clinical sites in the UK, Australia, Spain, Greece, Germany, Italy, Portugal, Japan, and Korea [5,12,13,14,15,16,17,18,19,20]. However, the psychometric properties of the Chinese version have not yet been examined.…”

Attention-Related Potentials Allow for a Highly Accurate Discrimination of Mild Cognitive Impairment Subtypes

“…Finally, nonamnestic cases with isolated dysexecutive deficits were defined as single-domain dysexecutive MCI (sd-dMCI) [3]. Overall, sd-aMCI and md-aMCI individuals may represent early Alzheimer's disease pathology [4,5] whereas naMCI are more prone to progress to frontotemporal, vascular or other types of dementia [6,7]. …”

Validation Study of the Italian Addenbrooke’s Cognitive Examination Revised in a Young-Old and Old-Old Population

“…The ACE – lately translated into Malayalam [7], French [8], Spanish [9], German [10], Hebrew [11], Danish [12] and Japanese [13 ]– was then revised (ACE-R) [14] in order to make the test easier to administer and to increase its sensitivity and specificity. In addition, three parallel forms were developed to avoid practice effects [14].…”