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A Comparison of the Greek ACE-III, M-ACE, ACE-R, MMSE, and ECAS in the Assessment and Identification of Alzheimer’s Disease

Published online by Cambridge University Press:  21 April 2020

Panagiotis Kourtesis*
Affiliation:
Department of Psychology, Human Cognitive Neuroscience, University of Edinburgh, Edinburgh, UK Lab of Experimental Psychology, Suor Orsola Benincasa University of Naples, Naples, Italy Interdepartmental Centre for Planning and Research “Scienza Nuova”, Suor Orsola Benincasa University of Naples, Naples, Italy
Eleni Margioti
Affiliation:
Department of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece Department of Psychology, Athens Alzheimer’s Association, Athens, Greece
Christina Demenega
Affiliation:
Department of Psychology, Athens Alzheimer’s Association, Athens, Greece
Foteini Christidi
Affiliation:
A’ Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
Sharon Abrahams
Affiliation:
Department of Psychology, Human Cognitive Neuroscience, University of Edinburgh, Edinburgh, UK Euan MacDonald Centre for Motor Neurone Disease Research, Royal Infirmary of Edinburgh, Edinburgh, UK
*
*Correspondence and reprint requests to: Panagiotis Kourtesis, 7 George Square, Edinburgh, EH8 9JZ, Scotland, UK. Email: [email protected]

Abstract

Objective:

This study aimed to adapt the Addenbrooke’s Cognitive Examination-III (ACE-III) and Mini-Addenbrooke’s Cognitive Examination (M-ACE) into Greek and then to examine the convergent validity against their predecessors Addenbrooke’s Cognitive Examination-Revised (ACE-R) and Mini-Mental State Examination (MMSE) in a Greek population. Moreover, a primary aim was to appraise the utility of each screen by conducting a comparison of the psychometric properties of ACE-III, M-ACE, ACE-R, MMSE, and the Edinburgh Cognitive and Behavioural Amyotrophic Lateral Sclerosis (ALS) Screen (ECAS) in detecting Alzheimer’s disease (AD).

Methods:

Forty patients with AD were recruited and matched with 38 controls. Bayesian Pearson’s correlation analysis was conducted to examine the convergent validity. Receiver operating characteristic curve analysis was implemented to appraise the sensitivity and specificity of the tests in detecting AD.

Results:

The ACE-III, M-ACE, and the ECAS scores robustly correlated with ACE-R and MMSE. The ACE-III and the ECAS-ALS Non-Specific score were the most sensitive and specific tools in detecting AD, closely followed by ECAS Total score and M-ACE. Only ECAS Total score correlated with the duration of disease. The ECAS scores were more resilient to ceiling effects than the other screens. M-ACE produced fewer ceiling effects than MMSE.

Conclusion:

The Greek ACE-III and M-ACE were successfully adapted and showed good convergent validity against their predecessors. They showed very good psychometric properties in detecting AD and may be considered in hectic clinical settings. ECAS Total score and ECAS-ALS Non-Specific showed comparable psychometric properties in the detection of AD and may be considered in polypathological clinics where motor impairments are common.

Type
Regular Research
Copyright
Copyright © INS. Published by Cambridge University Press, 2020

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References

REFERENCES

Abrahams, S., Newton, J., Niven, E., Foley, J., & Bak, T.H. (2014). Screening for cognition and behaviour changes in ALS. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 15(1–2), 914.CrossRefGoogle ScholarPubMed
Benedict, R.H., & Zgaljardic, D.J. (1998). Practice effects during repeated administrations of memory tests with and without alternate forms. Journal of Clinical and Experimental Neuropsychology, 20(3), 339352.CrossRefGoogle ScholarPubMed
Brugnolo, A., Nobili, F., Barbieri, M.P., Dessi, B., Ferro, A., Girtler, N., … Servetto, G. (2009). The factorial structure of the mini mental state examination (MMSE) in Alzheimer’s disease. Archives of Gerontology and Geriatrics, 49(1), 180185.10.1016/j.archger.2008.07.005CrossRefGoogle Scholar
Caga, J., Hsieh, S., Highton-Williamson, E., Zoing, M.C., Ramsey, E., Devenney, E., … Kiernan, M.C. (2018). The burden of apathy for caregivers of patients with amyotrophic lateral sclerosis. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 19(7–8), 599605.CrossRefGoogle ScholarPubMed
Cox, DR, Donnelly, CA. (2011). Principles of Applied Statistics. Cambridge, UK: Cambridge University Press.CrossRefGoogle Scholar
De Icaza Valenzuela, M.M., Bak, T.H., Pal, S., & Abrahams, S. (2018). The Edinburgh Cognitive and Behavioral ALS screen: relationship to age, education, IQ and the Addenbrooke’s Cognitive Examination-III. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 19(7–8), 585590.CrossRefGoogle ScholarPubMed
Dienes, Z. (2016). How Bayes factors change scientific practice. Journal of Mathematical Psychology, 72, 7889.CrossRefGoogle Scholar
Faul, F., Erdfelder, E., Lang, A.G., & Buchner, A. (2007). G* Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175191.CrossRefGoogle ScholarPubMed
Faul, F., Erdfelder, E., Buchner, A., & Lang, A.G. (2009). Statistical power analyses using G* Power 3.1: tests for correlation and regression analyses. Behavior Research Methods, 41(4), 11491160.CrossRefGoogle Scholar
Fields, J.A., Ferman, T.J., Boeve, B.F., & Smith, G.E. (2011). Neuropsychological assessment of patients with dementing illness. Nature Reviews Neurology, 7(12), 677.CrossRefGoogle ScholarPubMed
Foley, J.A., Niven, E.H., Paget, A., Bhatia, K.P., Farmer, S.F., Jarman, P.R., … Abrahams, S. (2018). Sensitivity and specificity of the ECAS in Parkinson’s disease and progressive supranuclear palsy. Parkinson’s Disease, 2018, 8. doi: 10.1155/2018/2426012Google ScholarPubMed
Folstein, M.F., Folstein, S.E., & Fanjiang, G. (2001). Mini-Mental State Examination: Clinical Guide. Lutz, FL: Psychological Assessment Resources.Google Scholar
Ganguli, M., Ratcliff, G., Huff, F.J., Belle, S., Kancel, M.J., Fischer, L., & Kuller, L.H. (1990). Serial sevens versus world backwards: a comparison of the two measures of attention from the MMSE. Topics in Geriatrics, 3(4), 203207CrossRefGoogle ScholarPubMed
Held, L., & Ott, M. (2018). On p-values and Bayes factors. Annual Review of Statistics and Its Application, 5, 393419.CrossRefGoogle Scholar
Hsieh, S., Hodges, J.R., Leyton, C.E., & Mioshi, E. (2012). Longitudinal changes in primary progressive aphasias: differences in cognitive and dementia staging measures. Dementia and Geriatric Cognitive Disorders, 34(2), 135141CrossRefGoogle ScholarPubMed
Hsieh, S., McGrory, S., Leslie, F., Dawson, K., Ahmed, S., Butler, C.R., … Hodges, J.R. (2015). The Mini-Addenbrooke’s Cognitive Examination: a new assessment tool for dementia. Dementia and Geriatric Cognitive Disorders, 39(1–2), 111.CrossRefGoogle ScholarPubMed
Hsieh, S., Schubert, S., Hoon, C., Mioshi, E., & Hodges, J.R. (2013). Validation of the Addenbrooke’s Cognitive Examination III in frontotemporal dementia and Alzheimer’s disease. Dementia and Geriatric Cognitive Disorders, 36(3–4), 242250.CrossRefGoogle ScholarPubMed
IBM Corp. Released 2016. IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp.Google Scholar
JASP Team. (2017). JASP (Version 0.8.1.2) [Computer software].Google Scholar
Kipps, C.M., Nestor, P.J., Dawson, C.E., Mitchell, J., & Hodges, J.R. (2008). Measuring progression in frontotemporal dementia: implications for therapeutic interventions. Neurology, 70(22), 20462052.CrossRefGoogle ScholarPubMed
Konstantinopoulou, E., Kosmidis, M.H., Ioannidis, P., Kiosseoglou, G., Karacostas, D., & Taskos, N. (2011). Adaptation of Addenbrooke’s Cognitive Examination-revised for the Greek population. European Journal of Neurology, 18(3), 442447.CrossRefGoogle ScholarPubMed
Kourtesis, P., Christidi, F., Margioti, E., Demenega, C., Rentzos, M., Evdokimidis, I., & Abrahams, S. (2019). The Edinburgh cognitive and behavioural amyotrophic lateral sclerosis screen: sensitivity in differentiating between ALS and Alzheimer’s disease in a Greek Population. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 21(1–2), 7885. doi: 10.1080/21678421.2019.1655059CrossRefGoogle Scholar
Lulé, D., Burkhardt, C., Abdulla, S., Böhm, S., Kollewe, K., Uttner, I., … Ludolph, A.C. (2015). The Edinburgh cognitive and behavioural amyotrophic lateral sclerosis screen: a cross-sectional comparison of established screening tools in a German-Swiss population. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 16(1–2), 1623.CrossRefGoogle Scholar
Marin, R.S. (1991). Apathy: a neuropsychiatric syndrome. The Journal of Neuropsychiatry and Clinical Neurosciences, 3(3), 243254.Google ScholarPubMed
Marsman, M., & Wagenmakers, E.J. (2017). Bayesian benefits with JASP. European Journal of Developmental Psychology, 14(5), 545555.CrossRefGoogle Scholar
Mathew, R., Bak, T.H., & Hodges, J.R. (2011). Screening for cognitive dysfunction in corticobasal syndrome: utility of Addenbrooke’s cognitive examination. Dementia and Geriatric Cognitive Disorders, 31(4), 254258.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E.M. (1984). Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA Work Group* under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology, 34(7), 939939.10.1212/WNL.34.7.939CrossRefGoogle ScholarPubMed
Mioshi, E., Dawson, K., Mitchell, J., Arnold, R., & Hodges, J.R. (2006). The Addenbrooke’s Cognitive Examination Revised (ACE-R): a brief cognitive test battery for dementia screening. International Journal of Geriatric Psychiatry: A Journal of the Psychiatry of Late Life and Allied Sciences, 21(11), 10781085.CrossRefGoogle ScholarPubMed
Mora, J.S., Salas, T., Fernández, M.C., Rodríguez-Castillo, V., Marín, S., Chaverri, D., & Rodríguez-Santos, F. (2018). Spanish adaptation of the edinburgh cognitive and behavioral amyotrophic lateral sclerosis screen (ECAS). Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 19(1–2), 7479.CrossRefGoogle Scholar
Niven, E., Newton, J., Foley, J., Colville, S., Swingler, R., Chandran, S., … Abrahams, S. (2015). Validation of the Edinburgh Cognitive and Behavioural Amyotrophic Lateral Sclerosis Screen (ECAS): a cognitive tool for motor disorders. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 16(3–4), 172179.CrossRefGoogle ScholarPubMed
Nunnally, J.C. (1994). Psychometric theory 3E. Tata McGraw-Hill Education.Google Scholar
Poletti, B., Solca, F., Carelli, L., Madotto, F., Lafronza, A., Faini, A., … Doretti, A. (2016). The validation of the Italian Edinburgh cognitive and behavioural ALS screen (ECAS). Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 17(7–8), 489498.CrossRefGoogle Scholar
Radakovic, R., & Abrahams, S. (2018). Multidimensional apathy: evidence from neurodegenerative disease. Current Opinion in Behavioral Sciences, 22, 4249.CrossRefGoogle Scholar
Radakovic, R., & Abrahams, S. (2014). Developing a new apathy measurement scale: Dimensional Apathy Scale. Psychiatry Research, 219(3), 658663.10.1016/j.psychres.2014.06.010CrossRefGoogle ScholarPubMed
Radakovic, R., Starr, J.M., & Abrahams, S. (2017). A novel assessment and profiling of multidimensional apathy in Alzheimer’s disease. Journal of Alzheimer’s Disease, 60(1), 5767.CrossRefGoogle ScholarPubMed
Raimondi, C., Gleichgerrcht, E., Richly, P., Torralva, T., Roca, M., Camino, J., & Manes, F. (2012). The Spanish version of the Addenbrooke’s Cognitive Examination—Revised (ACE-R) in subcortical ischemic vascular dementia. Journal of the Neurological Sciences, 322(1–2), 228231.CrossRefGoogle Scholar
Strong, M.J., Abrahams, S., Goldstein, L.H., Woolley, S., Mclaughlin, P., Snowden, J., … Rosenfeld, J. (2017). Amyotrophic lateral sclerosis-frontotemporal spectrum disorder (ALS-FTSD): revised diagnostic criteria. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 18(3–4), 153174.CrossRefGoogle ScholarPubMed
Valcour, V.G., Masaki, K.H., & Blanchette, P.L. (2002). The phrase:” no ifs, ands, or buts” and cognitive testing. Lessons from an Asian-American community. Hawaii Medical Journal, 61(4), 7274.Google ScholarPubMed
Wagenmakers, E.J., Love, J., Marsman, M., Jamil, T., Ly, A., Verhagen, J., … Meerhoff, F. (2018a). Bayesian inference for psychology. Part II: example applications with JASP. Psychonomic Bulletin & Review, 25(1), 5876.CrossRefGoogle ScholarPubMed
Wagenmakers, E.J., Marsman, M., Jamil, T., Ly, A., Verhagen, J., Love, J., … Matzke, D. (2018b). Bayesian inference for psychology. Part I: Theoretical advantages and practical ramifications. Psychonomic Bulletin & Review, 25(1), 3557.CrossRefGoogle ScholarPubMed
Weir, J.P. (2005). Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. The Journal of Strength & Conditioning Research, 19(1), 231240.Google ScholarPubMed
Ye, S., Ji, Y., Li, C., He, J., Liu, X., & Fan, D. (2016). The Edinburgh cognitive and behavioural ALS screen in a Chinese amyotrophic lateral sclerosis population. PloS one, 11(5), e0155496.CrossRefGoogle Scholar
Zigmond, A.S., & Snaith, R.P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361370.10.1111/j.1600-0447.1983.tb09716.xCrossRefGoogle ScholarPubMed