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      The Mini-Addenbrooke's Cognitive Examination: A New Assessment Tool for Dementia

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          Abstract

          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.

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          Most cited references25

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          Validation of the Addenbrooke's Cognitive Examination III in Frontotemporal Dementia and Alzheimer's Disease

          Background/Aims: The aims of this study were to validate the newly developed version of the Addenbrooke's Cognitive Examination (ACE-III) against standardised neuropsychological tests and its predecessor (ACE-R) in early dementia. Methods: A total of 61 patients with dementia (frontotemporal dementia, FTD, n = 33, and Alzheimer's disease, AD, n = 28) and 25 controls were included in the study. Results: ACE-III cognitive domains correlated significantly with standardised neuropsychological tests used in the assessment of attention, language, verbal memory and visuospatial function. The ACE-III also compared very favourably with its predecessor, the ACE-R, with similar levels of sensitivity and specificity. Conclusion: The results of this study provide objective validation of the ACE-III as a screening tool for cognitive deficits in FTD and AD.
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            Mokken Scale Analysis inR

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              Distinguishing Subtypes in Primary Progressive Aphasia: Application of the Sydney Language Battery

              Background/Aims: Primary progressive aphasia (PPA) comprises three main subtypes, varying in clinical features, patterns of brain atrophy, and underlying pathology. Differentiation of these variants is important for treatment and planning; however, simple, effective cognitive tests to aid diagnosis are lacking. This study introduces a new language battery - the SYDBAT (Sydney Language Battery) - to assist clinicians. Methods: Fifty-seven PPA patients and 54 age- and education-matched healthy controls were compared on naming, repetition, word comprehension, and semantic association subtests. Results: Significant group differences were found for all tasks, reflecting different language profiles for each group. Using discriminative function analysis, 80% of PPA cases were correctly classified from three SYDBAT scores, from which a simple diagnostic algorithm was defined. Conclusion: The SYDBAT is a fast and simple tool which provides a valuable adjunct to clinicians diagnosing PPA.
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                Author and article information

                Journal
                Dement Geriatr Cogn Disord
                Dement Geriatr Cogn Disord
                DEM
                Dementia and Geriatric Cognitive Disorders
                S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.ch )
                1420-8008
                1421-9824
                January 2015
                11 September 2014
                11 September 2014
                : 39
                : 1-2
                : 1-11
                Affiliations
                [1] aBrain and Mind Research Institute, University of New South Wales, Sydney, N.S.W., Australia
                [2] bNeuroscience Research Australia, University of New South Wales, Sydney, N.S.W., Australia
                [3] cARC Centre of Excellence in Cognition and Its Disorders, University of New South Wales, Sydney, N.S.W., Australia
                [4] dSchool of Medical Sciences, University of New South Wales, Sydney, N.S.W., Australia
                [5] eAlzheimer Scotland Dementia Research Centre, Department of Psychology, University of Edinburgh, Edinburgh, UK
                [6] fDepartments of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
                [7] gPsychiatry, Cambridge University, University of Oxford, John Radcliffe Hospital, Oxford, UK
                [8] hBehavioural and Clinical Neuroscience Institute, University of Oxford, John Radcliffe Hospital, Oxford, UK
                [9] iMedical Research Council, Cognition and Brain Sciences Unit, Cambridge, University of Oxford, John Radcliffe Hospital, Oxford, UK
                [10] jNuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
                Author notes
                *John R. Hodges, Neuroscience Research Australia, PO Box 1165, Randwick, NSW 2031 (Australia), E-Mail j.hodges@ 123456neura.edu.au
                Article
                dem-0039-0001
                10.1159/000366040
                4774042
                25227877
                dcd7fa25-b52c-4abc-b03c-3193f5b2cb7d
                Copyright © 2015 by S. Karger AG, Basel

                This is an Open Access article licensed under the terms of the Creative Commons Attribution 3.0 Unported license (CC BY 3.0) (www.karger.com/OA-license-WT), applicable to the online version of the article only. Users may download, print and share this work on the Internet, provided the original work is properly cited, and a link to the original work on http://www.karger.com and the terms of this license are included in any shared versions.

                History
                : 10 May 2014
                Page count
                Figures: 3, Tables: 3, References: 32, Pages: 11
                Categories
                Original Research Article

                Geriatric medicine
                cognitive screening test,frontotemporal dementia,alzheimer's disease,corticobasal degeneration

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