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. 2016 Dec 5;6(3):541-548.
doi: 10.1159/000450784. eCollection 2016 Sep-Dec.

The Utility of the Mini-Addenbrooke's Cognitive Examination as a Screen for Cognitive Impairment in Elderly Patients with Chronic Kidney Disease and Diabetes

Peter Hobson  1 , Kamel H Rohoma  2 , Stephen P Wong  1 , Mick J Kumwenda  1
Affiliations

The Utility of the Mini-Addenbrooke's Cognitive Examination as a Screen for Cognitive Impairment in Elderly Patients with Chronic Kidney Disease and Diabetes

Peter Hobson et al. Dement Geriatr Cogn Dis Extra. .

Abstract

Background/aims: We tested the utility of the Mini-Addenbrooke's Cognitive Examination (M-ACE) in a cohort of older adults with chronic kidney disease (CKD) and diabetes.

Method: The M-ACE was administered to 112 CKD and diabetes patients attending a nephrology clinic. Cognitive impairment was based upon patient, informant, and case review, neuropsychological assessment, and application of criteria for mild cognitive impairment (MCI) and the Diagnostic and Statistical Manual of Mental Disorders, fifth edition for dementia. The M-ACE was also compared to the Mini-Mental State Examination (MMSE).

Results: Upon assessment, 52 patients had normal cognitive function, 33 had MCI, and 27 had dementia. The area under the receiver operating curve for the M-ACE was 0.96 (95% CI 0.95-1.00). The sensitivity and specificity for a dementia diagnosis were 0.96 and 0.84 at the cut point <25 and 0.70 and 1.00 at the cut point <21. Mean M-ACE scores differed significantly between normal, demented, and MCI groups (p < 0.001), and compared to the MMSE, the M-ACE did not suffer from ceiling effects.

Conclusion: The M-ACE is an easily administered test with good sensitivity and specificity to capture and assist in the diagnosis of MCI or dementia in patients with CKD and diabetes.

Keywords: Chronic kidney disease; Diabetes; Mild cognitive impairment; Mini-Addenbrooke's Cognitive Examination; Screening for cognitive impairment.

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Conflict of interest statement

The authors in this investigation do not have a have any disclosures.

Figures

Fig. 1
Fig. 1
ROC curves of the M-ACE and MMSE sensitivity and specificity to detect cognitive impairment.
Fig. 2
Fig. 2
Error bar summarizing the distribution of the total M-ACE score by the DSM-V outcome. The circle in the middle of the bars represents the mean score and the whiskers are the 95% confidence intervals. NCI, no cognitive impairment.
See this image and copyright information in PMC

References

    1. Matthews FE, Arthur A, Barnes LE, et al. A two-decade comparison of prevalence of dementia in individuals aged 65 years and older from three geographical areas of England: results of the Cognitive Function and Ageing Study I and II. Lancet. 2013;382:1405–1412. - PMC - PubMed
    1. Rocca WA, Petersen RC, Knopman DS, et al. Trends in the incidence and prevalence of Alzheimer's disease, dementia, and cognitive impairment in the United States. Alzheimers Dement. 2011;7:80–93. - PMC - PubMed
    1. Parikh NI, Hwang S-J, Larson MG, et al. Chronic kidney disease as a predictor of cardiovascular disease (from the Framingham Heart Study) Am J Cardiol. 2008;102:47–53. - PMC - PubMed
    1. Dorsey ER, Constantinescu JP, Thompson KM, et al. Projected number of people with Parkinson's disease in the most populous nations, 2005 through 2030. Neurology. 2007;68:384–386. - PubMed
    1. Satizabal CL, Beiser AS, Chouraki V, et al. Incidence of Dementia over Three Decades in the Framingham Heart Study. N Engl J Med. 2016;374:523–532. - PMC - PubMed