MACE for the Diagnosis of Dementia and MCI: 3-Year Pragmatic Diagnostic Test Accuracy Study

Area of Science:

• Neurology
• Cognitive Science
• Diagnostic Accuracy Studies

Background:

• The Mini-Addenbrooke's Cognitive Examination (MACE) is a brief cognitive screening tool for dementia and mild cognitive impairment (MCI).
• Limited research exists on MACE's diagnostic performance.
• This study evaluated MACE in a large cohort within a specialized cognitive disorders clinic.

Purpose of the Study:

• To conduct a pragmatic diagnostic test accuracy study of MACE.
• To assess MACE's performance in identifying dementia and MCI in a secondary care setting.
• To evaluate MACE using various diagnostic test metrics.

Main Methods:

• MACE was administered to consecutive patients referred to a neurology-led Cognitive Function Clinic over three years.
• Diagnostic performance was assessed using sensitivity, specificity, positive predictive value, and negative predictive value.
• Criterion diagnosis was used as the gold standard for dementia and MCI.

Main Results:

• The study included 599 patients, with dementia prevalence of 17% and MCI prevalence of 29%.
• MACE demonstrated high sensitivity (>0.9) and negative predictive values (>0.8) for both dementia and MCI.
• MACE showed low specificity (<0.5) and positive predictive values (≤0.5).

Conclusions:

• MACE is a suitable tool for evaluating cognitive complaints in secondary care.
• The instrument shows strong performance in ruling out dementia and MCI.
• Further evaluation may be needed to enhance the positive predictive accuracy of MACE.