Mioshi Eneida, Dawson Kate, Mitchell Joanna, Arnold Robert, Hodges John R
MRC Cognition and Brain Sciences Unit, University of Cambridge, Department of Clinical Neurosciences, Addenbrooke's Hospital, UK.
Int J Geriatr Psychiatry. 2006 Nov;21(11):1078-85. doi: 10.1002/gps.1610.
There is a clear need for brief, but sensitive and specific, cognitive screening instruments as evidenced by the popularity of the Addenbrooke's Cognitive Examination (ACE).
We aimed to validate an improved revision (the ACE-R) which incorporates five sub-domain scores (orientation/attention, memory, verbal fluency, language and visuo-spatial).
Standard tests for evaluating dementia screening tests were applied. A total of 241 subjects participated in this study (Alzheimer's disease=67, frontotemporal dementia=55, dementia of Lewy Bodies=20; mild cognitive impairment-MCI=36; controls=63).
Reliability of the ACE-R was very good (alpha coefficient=0.8). Correlation with the Clinical Dementia Scale was significant (r=-0.321, p<0.001). Two cut-offs were defined (88: sensitivity=0.94, specificity=0.89; 82: sensitivity=0.84, specificity=1.0). Likelihood ratios of dementia were generated for scores between 88 and 82: at a cut-off of 82 the likelihood of dementia is 100:1. A comparison of individual age and education matched groups of MCI, AD and controls placed the MCI group performance between controls and AD and revealed MCI patients to be impaired in areas other than memory (attention/orientation, verbal fluency and language).
The ACE-R accomplishes standards of a valid dementia screening test, sensitive to early cognitive dysfunction.
正如Addenbrooke认知检查（ACE）的普及所证明的那样，显然需要简短但灵敏且特异的认知筛查工具。
我们旨在验证一种改进版本（ACE-R），它纳入了五个子领域得分（定向/注意力、记忆、语言流畅性、语言和视觉空间）。
应用了评估痴呆筛查测试的标准测试。共有241名受试者参与了本研究（阿尔茨海默病=67例，额颞叶痴呆=55例，路易体痴呆=20例；轻度认知障碍-MCI=36例；对照组=63例）。
ACE-R的信度非常好（α系数=0.8）。与临床痴呆评定量表的相关性显著（r=-0.321，p<0.001）。定义了两个临界值（88：灵敏度=0.94，特异度=0.89；82：灵敏度=0.84，特异度=1.0）。生成了88至82分之间痴呆的似然比：在临界值为82时，痴呆的可能性为100:1。对MCI、AD和对照组的个体年龄和教育匹配组进行比较，发现MCI组的表现介于对照组和AD组之间，并且显示MCI患者在记忆以外的领域（注意力/定向、语言流畅性和语言）存在损害。
ACE-R达到了有效痴呆筛查测试的标准，对早期认知功能障碍敏感。
