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The Mini-Addenbrooke's Cognitive Examination: a new assessment tool for dementia
Sharpley Hsieh1, Sarah McGrory, Felicity Leslie
1Brain and Mind Research Institute, University of New South Wales, Sydney, N.S.W., Australia.
Background/Aims:
We developed and validated the Mini-Addenbrooke's Cognitive Examination (M-ACE) in dementia patients. Comparisons were also made with the Mini Mental State Examination (MMSE).
Method:
The M-ACE was developed using Mokken scaling analysis in 117 dementia patients [behavioural variant frontotemporal dementia (bvFTD), n = 25; primary progressive aphasia (PPA), n = 49; Alzheimer's disease (AD), n = 34; corticobasal syndrome (CBS), n = 9] and validated in an independent sample of 164 dementia patients (bvFTD, n = 23; PPA, n = 82; AD, n = 38; CBS, n = 21) and 78 controls, who also completed the MMSE.
Results:
The M-ACE consists of 5 items with a maximum score of 30. Two cut-offs were identified: (1) ≤25/30 has both high sensitivity and specificity, and (2) ≤21/30 is almost certainly a score to have come from a dementia patient regardless of the clinical setting. The M-ACE is more sensitive than the MMSE and is less likely to have ceiling effects.
Conclusion:
The M-ACE is a brief and sensitive cognitive screening tool for dementia. Two cut-offs (25 or 21) are recommended.
Insights
The Mini-Addenbrooke's Cognitive Examination (M-ACE) is a new, sensitive dementia screening tool. It is more effective than the Mini Mental State Examination (MMSE) and offers two recommended cut-offs for diagnosis.
Area of Science:
- Neurology
- Cognitive Science
- Psychometrics
Background:
- Dementia diagnosis requires sensitive screening tools.
- Existing tools like the Mini Mental State Examination (MMSE) have limitations.
Purpose of the Study:
- To develop and validate the Mini-Addenbrooke's Cognitive Examination (M-ACE) for dementia screening.
- To compare the M-ACE's performance against the MMSE.
Main Methods:
- The M-ACE was developed using Mokken scaling analysis.
- Validation involved 117 dementia patients and an independent sample of 164 dementia patients and 78 controls.
- Participants completed both M-ACE and MMSE.
Main Results:
- The M-ACE has 5 items with a maximum score of 30.
- Cut-offs of ≤25/30 (high sensitivity/specificity) and ≤21/30 (high certainty of dementia) were identified.
- M-ACE demonstrated higher sensitivity and fewer ceiling effects than MMSE.
Conclusions:
- The M-ACE is a brief, sensitive cognitive screening tool for dementia.
- Recommended cut-offs are 25/30 and 21/30.
- The M-ACE is a valuable alternative to the MMSE.
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