Validation of the Chinese version of Addenbrooke’s cognitive examination III for detecting mild cognitive impairment

Abstract

Objectives

To evaluate the reliability and validity of Chinese version of Addenbrooke’s Cognitive Examination III (ACE-III-CV) in the identification of mild cognitive impairment (MCI), and further investigate the optimal cutoff scores according to different age and education level.

Method

A total of 716 individuals aged from 50 to 90 years old were recruited through internet-based and print advertisements, including 431 cognitively normal controls (NC) and 285 individuals with MCI according to an actuarial neuropsychological method put forward by Jak and Bondi. Besides the cognitive screening tests of ACE-III-CV, Mini-Mental State Examination (MMSE) and Chinese version of Montreal Cognitive Assessment-Basic (MoCA-BC), all the participants underwent a battery of standardized neuropsychological tests. Validations of the ACE-III-CV, MMSE, and MoCA-BC for detecting MCI from NC were determined by Receiver operating characteristic (ROC) curves.

Results

ACE-III-CV had a good reliability (Cronbach’s coefficient α = 0.807, intraclass correlation coefficients for interrater and test-retest reliability were 0.95 and 0.93). According to the area under ROC curve (AUC), ACE-III-CV and MoCA-BC showed better ability than MMSE in detecting MCI. No significant difference was found between ACE-III-CV and MoCA-BC. The optimal cutoff scores of ACE-III-CV for screening MCI were 72 for individuals with 1-9 years of education, 78 for individuals with 10-15 years of education, and 80 for individuals with more than 16 years of education.

Conclusion

The Chinese version of ACE-III-CV is a reliable and valid screening tool for detecting MCI. The optimal cutoff scores are closely related with education level.

Keywords:

• Mild cognitive impairment (MCI)
• Alzheimer’s disease (AD)
• Addenbrooke’s Cognitive Examination III (ACE-III)
• Mini-Mental State Examination (MMSE)
• Montreal Cognitive Assessment-Basic (MoCA-B)

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics approval and consent to participate

This study was approved by the Shanghai Jiao Tong University Affiliated Sixth People’s Hospital Foundation Ethical Committee. Written informed consent was obtained from all individual participants included in the study.

Additional information

Funding

This work was supported by the National Key R&D Program of China under grant number 2016YFC1306305; Guangdong Provincial Key S&T Program under grant number 2018B030336001.