Addenbrooke's Cognitive Examination validation in Parkinson's disease
M A Reyes1, S Perez-Lloret, S P Lloret
1Movement Disorders Section, Neuroscience Department and Cognitive Department, Institute for Neurological Research Raul Carrea FLENI, Buenos Aires, Argentina.
European Journal of Neurology
|December 4, 2008
Summary
Addenbrooke's Cognitive Examination (ACE) is a valid tool for assessing dementia in Parkinson's disease (PD) patients. It shows high correlation with other cognitive scales, suggesting its utility for PD cognitive evaluation.
Area of Science:
- Neurology
- Cognitive Science
- Geriatrics
Background:
- Parkinson's disease (PD) requires brief, sensitive, and specific cognitive screening tools.
- Existing cognitive assessments may not fully capture the nuances of cognitive impairment in PD.
Purpose of the Study:
- To evaluate the validity of Addenbrooke's Cognitive Examination (ACE) for cognitive assessment in Parkinson's disease (PD) patients.
- To compare ACE's performance against the Mattis Dementia Rating Scale (MDRS) as a reference standard.
- To assess the correlation of ACE with the Scales for Outcomes of Parkinson's disease-Cognition (SCOPA-COG) and the Mini-Mental State Examination (MMSE).
Main Methods:
- Forty-four PD patients participated in the study.
- Cognitive assessments included MDRS, ACE, SCOPA-COG, and MMSE, administered in random order.
- Patient demographics and disease characteristics (age, disease duration, UPDRS scores) were recorded.
Main Results:
- ACE demonstrated strong correlations with SCOPA-COG (r=0.93) and MDRS (r=0.91).
- The area under the receiver-operating curve for ACE was 0.97, indicating high diagnostic accuracy compared to MDRS.
- An ACE cut-off score of 83 yielded high sensitivity (92%) and specificity (91%) for dementia detection in PD.
Conclusions:
- Addenbrooke's Cognitive Examination (ACE) is a valid and reliable tool for dementia evaluation in Parkinson's disease (PD).
- A recommended cut-off score of 83 for ACE provides good diagnostic performance.
- ACE shows strong concordance with disease-specific (SCOPA-COG) and general cognitive scales (MMSE).
Related Concept Videos
01:15Parkinson's Disease: Overview
Neurodegenerative disorders are progressive diseases that cause irreversible damage and loss to neurons in specific brain areas. Examples of these disorders include Parkinson's disease, Alzheimer's disease, Multiple Sclerosis (MS), and Amyotrophic Lateral Sclerosis (ALS). These disorders share characteristics such as proteinopathies, selective neuronal vulnerability, and a complex interplay between genetic and environmental factors. The primary therapeutic goal for these conditions is to...
01:24Parkinson Disease l: Introduction
Parkinson’s disease is a chronic, progressive neurodegenerative disorder that primarily affects movement. It is characterized by motor symptoms such as resting tremors, muscle rigidity, bradykinesia (slowness of movement), and postural instability. Patients may notice hand tremors at rest, stiffness during movement, or a shuffling gait. In addition to motor features, non-motor symptoms include sleep disturbances, mood and behavioral changes, constipation, and cognitive impairment, all of which...
01:24Parkinson Disease ll: Pathophysiology
Parkinson disease (PD) is a progressive neurodegenerative disorder primarily affecting movement, with additional non-motor features. Its pathophysiology involves complex interactions among genetic susceptibility, environmental exposures, and cellular dysfunction, including dopaminergic neuron loss, protein aggregation, and mitochondrial impairment.Selective NeurodegenerationA key feature is the degeneration of dopaminergic neurons in the substantia nigra pars compacta, leading to reduced...
01:24Parkinson's Disease: Treatment
Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of its...
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of its...
01:26Alzheimer's Disease: Overview
Alzheimer's Disease (AD) is a continually advancing neurodegenerative disorder, distinguished by escalating memory loss, cognitive dysfunction, and dementia. The disease unfolds in three stages: preclinical, mild cognitive impairment (MCI), and dementia. Its onset is insidious, and the progression gradual, with the cause not well explained by other disorders.
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ and tau...
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ and tau...
01:29Alzheimer Disease l: Introduction
Alzheimer disease is a chronic, progressive, and irreversible neurodegenerative disorder and the most common cause of dementia in older adults. It leads to gradual neuronal loss, causing cognitive decline, behavioral changes, and loss of functional independence.Risk Factors and EtiologyThe disease is multifactorial. Age is the strongest risk factor, with prevalence doubling every 5 years after age 65. Genetic factors include mutations in genes such as APP, PSEN1, and PSEN2, which are associated...