Cognitive Assessment of Dementia in Incarcerated Populations: The Utility of the Addenbrooke's Cognitive Examination...

There are many reasons why people experiencing incarceration may be predisposed to developing dementia. Dementia assessment in prisons is challenging. This study assessed the Addenbrooke's Cognitive Examination 3rd Edition (ACE-III) and the Mini Addenbrooke's Cognitive Examination (M-ACE) as potential tools for use in incarcerated populations, with a view to detecting suspected dementia. The ACE-III was administered to 114 males more than 50 years of age without a diagnosis of dementia across three prison sites in Victoria, Australia, in 2022. A psychogeriatrician reviewed data for atypical response patterns to determine whether individuals' profiles were suggestive of dementia. The M-ACE was scored retrospectively from the ACE-III. Scores were compared with the psychogeriatrician's review to determine concordance rates. Both tools acceptably discriminated males who indicated dementia from those without (area under the curve [AUC] = 0.77, [0.65, 0.98]; AUC = 0.77, [0.60, 0.93], respectively). Both tools produced high negative predictive values (0.96 and 0.97). Both the ACE-III and M-ACE demonstrated utility for use in this cohort. The M-ACE may be an useful tool for screening out individuals who do not have dementia, while the ACE-III provides a comprehensive cognitive profile as a basis to assess for dementia.