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Clinical characteristics and diagnostic accuracy of the revised Addenbrooke Cognitive Examination (ACE-R) in older adults with a low educational level

2021; UNIVERSIDADE FEDERAL DO RIO DE JANEIRO; Volume: 70; Issue: 1 Linguagem: Inglês

10.1590/0047-2085000000310

ISSN

1982-0208

Autores

José Wagner Leonel Tavares-Júnior, Pedro Braga‐Neto, Janine de Carvalho Bonfadini, Lays Bittencourt, Candida Helena Lopes, Larissa Mendes, José Ibiapina Siqueira Neto, Valéria Sousa, Anina Amaral, Carolina Gomes Carrilho, Jonatan Oliveira Espindola, Maria Eduarda Avancini Casali, André Barciela Veras, Gilberto Sousa Alves,

Tópico(s)

Frailty in Older Adults

Resumo

ABSTRACT Objective: To determine the diagnostic accuracy of the Addenbrooke’s Cognitive Examination Revised (ACE-R) as a cognitive screening tool for older adults with low levels of schooling and healthy aging, MCI and dementia in Brazil. Methods: All participants underwent neurological and psychiatric examinations and were administered a validated version of ACE-R. Results: A total of 85 participants were evaluated; most were females (84.7%, n = 72). The post hoc analysis showed statistical differences in ACE-R total scores between older adults with mild cognitive impairment (MCI) and controls (p < 0.001) and in subitem scores including verbal fluency, language, visuospatial skills and attention (p < 0.001). The visual-spatial skills subitem was the most strongly correlated with schooling level (r = 0.509, p < 0.001), whereas late, immediate recall and recognition memory were not influenced by schooling. The ACE-R had the best diagnostic accuracy in discriminating between MCI and controls = 0.69 (<57.5; 80/66), MD and controls = 0.98 (<50; 100/96), MCI and MD = 0.86 (<49.5; 100/74). Conclusions: ACE-R and Mini-Mental State Examination (MMSE) scores for older adults with MCI and controls were significantly lower than those reported in similar studies. These preliminary findings support the need for establishing reliable cut-off scores for cognitive assessment of older Brazilian adults with low schooling at risk for dementia taking into consideration ecological and local variables.

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