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Addenbrooke's cognitive examination-revised: normative and accuracy data for seniors with heterogeneous educational level in Brazil

Published online by Cambridge University Press:  17 May 2017

Karolina G. César Open the ORCID record for Karolina G. César [Opens in a new window] ,
Mônica S. Yassuda ,
Fabio H. G. Porto ,
Sonia M. D. Brucki  and
Ricardo Nitrini
Karolina G. César*
Affiliation:
Study conducted by the Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
Mônica S. Yassuda
Affiliation:
Study conducted by the Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
Fabio H. G. Porto
Affiliation:
Study conducted by the Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
Sonia M. D. Brucki
Affiliation:
Study conducted by the Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
Ricardo Nitrini
Affiliation:
Study conducted by the Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
*
Correspondence should be addressed to: Karolina G. César, Av Armando Salles de Oliveira 200, ap 42 Taubaté - São Paulo - Brazil, Zip Code 12030–080. Phone: +55 12 99102-9307; Fax: +55 12 3631-5212. Email: karolgcesar@gmail.com.
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Abstract

Background:

Several cognitive tools have been developed aiming to diagnose dementia. The cognitive battery Addenbrooke's Cognitive Examination – Revised (ACE-R) has been used to detect cognitive impairment; however, there are few studies including samples with low education. The aim of the study was to provide ACE-R norms for seniors within a lower education, including illiterates. An additional aim was to examine the accuracy of the ACE-R to detect dementia and cognitive impairment no dementia (CIND).

Methods:

Data originated from an epidemiological study conducted in the municipality of Tremembé, Brazil. The Brazilian version of ACE-R was applied as part of the cognitive assessment in all participants. Of the 630 participants, 385 were classified as cognitively normal (CN) and were included in the normative data set, 110 individuals were diagnosed with dementia, and 135 were classified as having CIND.

Results:

ACE-R norms were provided with the sample stratified into age and education bands. ACE-R total scores varied significantly according to age, education, and sex. To distinguish CN from dementia, a cut-off of 64 points was established (sensitivity 91%, specificity 76%) and to differentiate CN from CIND the best cut-off was 69 points (sensitivity 73%, specificity 65%). Cut-off scores varied according to the educational level.

Conclusions:

This study offers normative and accuracy parameters for seniors with lower education and it should expand the use of the ACE-R for this population segment.

Keywords

dementiaepidemiologycognitive testingscreeningmild cognitive impairment
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 8 , August 2017 , pp. 1345 - 1353
Copyright
Copyright © International Psychogeriatric Association 2017 

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