A Validation Study of the Chinese Version of the Mini-Addenbrooke's Cognitive Examination for Screening Mild Cognitive Impairment and Mild Dementia

Abstract

Background/aims: There are limited cognitive screening tests for the Chinese-speaking population. This study aimed to validate the Chinese version of the Mini-Addenbrooke's Cognitive Examination (M-ACE) for detecting mild cognitive impairment (MCI) and mild dementia. Its diagnostic accuracy was compared with that of Mini-Mental State Examination (MMSE). The study also evaluated the influential factors of M-ACE scores and its convergent validity against Clinical Dementia Rating Scale (CDR) and MMSE.

Method: One hundred sixty-nine participants were classified into 3 groups: mild dementia, MCI, and healthy control. Mini-Mental State Examination and M-ACE were administered by researchers who were blinded to the clinical grouping. Receiver operating characteristic curves were graphed to test the diagnostic accuracy.

Results: Mini-Addenbrooke's Cognitive Examination scores had good convergent validity against CDR and MMSE. Years of education ( r = 0.4, P < .001) yielded significant impacts on M-ACE scores. The optimal cutoff score of M-ACE to detect MCI was 25/26 (sensitivity = 0.88; specificity = 0.72) with an area under curve (AUC) significantly higher than MMSE (0.86 vs 0.72). The optimal cutoff score of M-ACE to screen mild dementia (21/22) yielded satisfactory sensitivity (0.96) and specificity (0.87) with a comparable AUC to MMSE (0.96 vs 0.94).

Conclusions: Mini-Addenbrooke's Cognitive Examination was a brief and reliable tool to detect MCI and mild dementia in the Chinese-speaking population significantly superior to MMSE when detecting MCI.

Keywords: Mini Addenbrooke’s Cognitive Examination; cognitive screening test; mild cognitive impairment; mild dementia.