Aim: To examine whether education adjusted cut-off points of the Thai version of the ACE-III improve diagnostic accuracy in the detection of mild cognitive impairment (MCI) and dementia. Materials & methods: There were 172 participants consisting of 70 normal controls, 49 people with MCI and 53 patients with dementia. Results: To screen for MCI, the adjusted for education method yielded greater accuracy for the area under the receiver operating characteristic curve (AuROC) than the unadjusted method (0.9-0.92 vs 0.86). For the detection of dementia, when applying the education correction, AuROC increased from 0.87 (unadjusted) to 0.91 for the education >6 group, but there was no improvement for education ≤6 group (AuROC 0.86). Conclusion: The use of adjusted cut-off score for education level could increase the diagnostic accuracy of the test.
Keywords: Addenbrooke’s Cognitive Examination; Alzheimer’s disease; dementia; mild cognitive impairment.
Lay abstract This study aimed to evaluate the ability of the Thai version of the Addenbrooke’s Cognitive Examination-III to detect mild cognitive impairment and dementia. Since educational level often affects cognitive test performance, in this study we adjusted the cut-off score according to the educational level to improve the test utility. Our results show that the Thai version of the Addenbrooke’s Cognitive Examination-III is a valid cognitive instrument for detecting mild cognitive impairment and dementia. In addition, adjusting the cut-off scores for education level is found to enhance the accuracy of the test.