Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Int Psychogeriatr. 2012 Jan;24(1):28-37. doi: 10.1017/S1041610211001190. Epub 2011 Aug 16.
Early detection of dementia will be important for implementation of disease-modifying treatments in the near future. We aimed to investigate the diagnostic validity and reliability of the Japanese version of the revised Addenbrooke's Cognitive Examination (ACE-R J) for identifying mild cognitive impairment (MCI) and dementia.
We translated and adapted the original ACE-R for use with a Japanese population. Standard tests for evaluating cognitive decline and dementing disorders were applied. A total of 242 subjects (controls = 73, MCI = 39, dementia = 130) participated in this study.
The optimal cut-off scores of ACE-R J for detecting MCI and dementia were 88/89 (sensitivity 0.87, specificity 0.92) and 82/83 (sensitivity 0.99, specificity 0.99) respectively. ACE-R J was superior to the Mini-Mental State Examination in the detection of MCI (area under the curve (AUC): 0.952 vs. 0.868), while the accuracy of the two instruments did not differ significantly in identifying dementia (AUC: 0.999 vs. 0.993). The inter-rater reliability (ICC = 0.999), test-retest reliability (ICC = 0.883), and internal consistency (Cronbach's α = 0.903) of ACE-R J were excellent.
ACE-R J proved to be an accurate cognitive instrument for detecting MCI and mild dementia. Further neuropsychological evaluation is required for the differential diagnosis of dementia subtypes.
早期发现痴呆症对于未来实施疾病修饰治疗至关重要。我们旨在研究经修订的 Addenbrooke 认知测验（ACE-R J）的日文版在识别轻度认知障碍（MCI）和痴呆症方面的诊断准确性和可靠性。
我们翻译并改编了 ACE-R 的原始版本，以适用于日本人群。应用了评估认知能力下降和痴呆症的标准测试。共有 242 名受试者（对照组=73，MCI=39，痴呆症=130）参与了这项研究。
ACE-R J 检测 MCI 和痴呆症的最佳截断分数分别为 88/89（敏感性 0.87，特异性 0.92）和 82/83（敏感性 0.99，特异性 0.99）。ACE-R J 在检测 MCI 方面优于简易精神状态检查（AUC：0.952 与 0.868），而两种仪器在识别痴呆症方面的准确性没有显著差异（AUC：0.999 与 0.993）。ACE-R J 的组内一致性（ICC=0.999）、重测信度（ICC=0.883）和内部一致性（Cronbach's α=0.903）均极佳。
ACE-R J 被证明是一种准确的认知工具，可用于检测 MCI 和轻度痴呆症。需要进一步的神经心理学评估来进行痴呆症亚型的鉴别诊断。
