4.3 Article

Applying ACE-III, M-ACE and MMSE to Diagnostic Screening Assessment of Cognitive Functions within the Polish Population

Publisher

MDPI
DOI: 10.3390/ijerph191912257

Keywords

cognitive screening tests; Addenbrooke's cognitive examination; mini-Addenbrooke's cognitive examination; mini-mental state examination

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The research compares the accuracy of MMSE, ACE-III, and M-ACE in the Polish population and investigates their potential as predictors for early dementia. The study finds a high correlation and sensitivity between the three tests. ACE-III is recommended for specialized diagnostic centers, while M-ACE is a suitable alternative for primary health care centers.
The research aims to compare the accuracy of the mini-mental state examination (MMSE), the Addenbrooke's cognitive examination III (ACE-III) and the mini-Addenbrooke's cognitive examination (M-ACE) within the Polish population. The model comprised several stages: the features of each test were compared; the shifts in result categorisations between the norm and below the norm were analysed; a third category-mild cognitive impairment (MCI)-was included. Additionally, particular ACE-III domains that scored below domain-specific norm thresholds were analysed to establish the potential early predictors of dementia. All tests correlated to a high and very high degree-cf. MMSE and ACE-III (r = 0.817; p < 0.001), MMSE and M-ACE (r = 0.753; p < 0.001), ACE-III and M-ACE (r = 0.942; p < 0.001). The area under the ROC curve for the ACE-III diagnostic variable had a high value (AUC = 0.920 +/- 0.014). A cut-off point of 81 points was suggested for ACE-III; the M-ACE diagnostic variable had an equally high value (AUC = 0.891 +/- 0.017). A cut-off point of 20 points was suggested. A significant decrease in the mean score values for people who scored norm or below the norm under ACE-III, as compared to the MMSE results for norm (p < 0.0001), occurred for speech fluency (which decreased by 26.4%). The tests in question are characterised by high sensitivity and specificity. Targeted ACE-III seems best recommended for use in specialised diagnostic centres, whereas M-ACE appears to be a better suited diagnostic alternative for primary health care centres in comparison to MMSE.

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