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