Addenbrooke’s cognitive examination III in the diagnosis of dementia: a critical review

Figures & data

Table 1 Cognitive domain, tasks, and sub-total score of ACE-III

Cognitive domains	Tasks	Sub-total score
Attention	Attention is tested by asking the patient about the date, including the season and the current location; repeating back three simple words; and serial subtraction	18 points
Memory	Memory is tested by asking the patient to recall three words previously repeated; memorizing and recalling a fictional name and address; and recalling widely known historical facts	26 points
Fluency	Fluency is tested by asking the patient to say as many words as they can think of starting with a specified letter within 1 minute; and naming as many animals as they can think of in 1 minute	14 points
Language	Language is tested by asking the patient to complete a set of sequenced physical commands using a pencil and piece of paper such as “place the paper on top of the pencil,” to write two grammatically complete sentences, to repeat several polysyllabic words and two short proverbs; to name the objects shown in 12 line drawings, and to answer contextual questions about some of the objects; and to read words with irregular sound-spelling correspondence	26 points
Visuospatial	Visuospatial abilities are tested by asking the patient to copy two diagrams, to draw a clock face with the hands set at a specified time, to count sets of dots, and to recognize four fragmented letters	16 points

Abbreviation: ACE-III, Addenbrooke’s cognitive examination III.

Table 2 Different versions of ACE-III currently available

Languages	Authors	Year	Patient	Cutoff score	Sensitivity	Specificity
English	Jubb and Evans^Citation37	2015	Dementia (n=33) No dementia (n=26)	81	79	96
English	Hsieh et al^Citation4	2013	Fronto-temporal dementia (n=33) Alzheimer’s disease (n=28) Healthy controls (n=25)	88	100	96
English	Elamin et al^Citation28	2016	Subjective memory impairment (n=15) Alzheimer’s disease (n=31) Primary progressive aphasia (n=11) Behavioural-variant fronto-temporal dementia (n=18) Posterior cortical atrophy (n=11) Healthy controls (n=28)	88	91.5	96.4
Portuguese	Peixoto et al^Citation54	2018	Healthy controls (n=30) MCI (n=30) Dementia (n=30)	82	87.5	57.14
Spanish (European)	Matias-Guiu et al^Citation44	2015	Dementia (n=87) Healthy controls (n=130)	65.6	83	80
Spanish (European)	Matias-Guiu et al^Citation7	2017	Healthy controls (n=25) Subjective memory complaints (n=48) Amnestic MCI (n=47) Mild Alzheimer’s disease (n=47) Other neurodegenerative diseases (n=33)	73/74	76.6	75
Spanish (European)	Matías-Guiu et al^Citation38	2016	Healthy controls (n=273)	7/8a	83.1	92.4
Spanish (Argentinian)	Bruno et al^Citation31	2018	Fronto-temporal dementia (n=31) Alzheimer’s disease, (n=70) Healthy controls (N=139)	86	98.5	82.01
Egyptian Arabic	Qassem et al^Citation55	2015	Healthy controls (N=139)	b
Italian	Pigliautile et al^Citation46	2018	Healthy controls (N=574)	c
Thai	Charernboon et al^Citation56	2016	Dementia (n=30) MCI (n=29) Healthy controls (n=48)	61	100	97
Chinese	Wang et al^Citation15	2017	Dementia (N=177) Healthy controls (N=180)	83	91.1	83.1

Notes:

a The author proposes a correction by age, gender, and level of education.

b The author proposes percentiles by the total score and subtest, and no cutoff.

c The author proposes a correction by age, gender, and level of education use the cutoff original.

Abbreviations: ACE-III, Addenbrooke’s cognitive examination III; MCI, mild cognitive impairment.

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