Cut-off scores for mild and moderate dementia on the Addenbrooke's Cognitive Examination-III and the Mini-Addenbrooke's Cognitive Examination compared with the Mini-Mental State Examination

Louise McCarthy; Judy Rubinsztein; Ellen Lowry; Emma Flanagan; Vandana Menon; Silvia Vearncombe; Eneida Mioshi; Michael Hornberger

doi:10.1192/bjb.2023.27

Cut-off scores for mild and moderate dementia on the Addenbrooke's Cognitive Examination-III and the Mini-Addenbrooke's Cognitive Examination compared with the Mini-Mental State Examination

BJPsych Bull. 2024 Feb;48(1):12-18. doi: 10.1192/bjb.2023.27.

Authors

Louise McCarthy¹, Judy Rubinsztein², Ellen Lowry³, Emma Flanagan³, Vandana Menon², Silvia Vearncombe², Eneida Mioshi⁴, Michael Hornberger³

Affiliations

¹ Norfolk and Suffolk NHS Foundation Trust, Norwich, UK.
² Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK.
³ Norwich Medical School, University of East Anglia, Norwich, UK.
⁴ School of Health Sciences, University of East Anglia, Norwich, UK.

Abstract

Aims and method: We aimed to establish cut-off scores to stage dementia on the Addenbrooke's Cognitive Examination-III (ACE-III) and the Mini-Addenbrooke's Cognitive Examination (M-ACE) compared with scores traditionally used with the Mini-Mental State Examination (MMSE). Our cross-sectional study recruited 80 patients and carers from secondary care services in the UK.

Results: A score ≤76 on the ACE-III and ≤19 on the M-ACE correlated well with MMSE cut-offs for mild dementia, with a good fit on the receiver operating characteristic analysis for both the ACE-III and M-ACE. The cut-off for moderate dementia had lower sensitivity and specificity. There were low to moderate correlations between the cognitive scales and scales for everyday functioning and behaviour.

Clinical implications: Our findings allow an objective interpretation of scores on the ACE-III and the M-ACE relative to the MMSE, which may be helpful for clinical services and research trials.

Keywords: Carers; community mental health teams; dementia; psychological testing; rating scales.