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Addenbrooke's Cognitive Examination-III (ACE-III)
Addenbrooke's Cognitive Examination-III (ACE-III)
| Availability |
Please visit this website for more information about the instrument: Addenbrooke's Cognitive Examination-III
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| Classification |
Supplemental: Parkinson's Disease (PD)
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| Short Description of Instrument |
Purpose: The Addenbrooke's Cognitive Examination was designed as a simple bedside test battery to detect mild dementia and differentiate Alzheimer's disease (AD) from frontotemporal dementia (FTD), and to overcome some of the omissions in the Mini-Mental State Examination (MMSE). The Addenbrooke's Cognitive Examination-III (ACE-III) was developed from the Addenbrooke's Cognitive Examination-Revised (ACE-R) by removing the MMSE-items, but has strong correlations with ACE-R.
Overview: The ACE-III is a brief cognitive test that assesses five cognitive domains, and replaces the previous ACE-R. It was developed at Neuroscience Research Australia (NeuRA; https://www.neura.edu.au/). Administration of the ACE-III takes, on average, 15 minutes and scoring takes about 5 minutes.
Construct measured: Global cognitive function (specific on 5 domains: attention and orientation, memory, verbal fluency, language and visuospatial skills).
Generic vs. disease-specific: Generic.
Means of administration: Examiner administered, six pages, requiring pen and paper.
Intended respondent (e.g., patient, caregiver, etc.): Patient.
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| Scoring and Psychometric Properties |
Scoring: 18 points attention and orientation; 26 points memory; 14 points verbal fluency; 26 points language; 16 points visuospatial skills. Maximum = 100. Higher = better cognition. Scoring and administration guidelines can be accessed at: The University of Sydney Brain and Mind Centre.
Psychometric Properties: In PD, best cut-offs for mild cognitive impairment (MCI) were reported to be 83.5 (education 0-8 years) and 85.5 points (education 9-12 years) and 88.5 points for persons with more than 12 years of education. Sensitivities ranged from 0.769 to 0.931 while specificity ranged from 0.643 to 0.786. For dementia recommended cutoffs were 70.5 ,77.5 and 78.5 points for the same education levels; sensitivity ranged from 0.805 to 0.957, specificity from 0.740 to 0.927 (Lucza, 2018).
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| Rationale/Justification |
Strengths: A copyright-free alternative to MMSE. Brief screening, provides subdomain scores, easy to administer, supported by clinimetrics.
Weaknesses: Not often used in PD; as a screening test provides only superficial neuropsychological evidence, and not adequate to identify MCI.
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| References |
Key Reference:
Mathuranath PS, Nestor PJ, Berrios GE, Rakowicz W, Hodges JR. A brief cognitive test battery to differentiate Alzheimer's disease and frontotemporal dementia. Neurology. 2000 Dec 12;55(11):1613-20.
Additional References:
Hsieh S, McGrory S, Leslie F, Dawson K, Ahmed S, Butler CR, Rowe JB, Mioshi E, Hodges JR. The Mini-Addenbrooke's Cognitive Examination: a new assessment tool for dementia. Dement Geriatr Cogn Disord. 2015;39(1-2):1-11.
Hsieh S, Schubert S, Hoon C, Mioshi E, Hodges JR. Validation of the Addenbrooke's Cognitive Examination III in frontotemporal dementia and Alzheimer's disease. Dement Geriatr Cogn Disord. 2013;36(3-4):242-50.
Lucza T, Ascherman Z, Kovacs M, Makkos A, Harmat M, Juhasz A, Janszky J, Komoly S, Kovacs N, Dorn K, Karadi K. Comparing Sensitivity and Specificity of Addenbrooke's Cognitive Examination-I, III and Mini-Addenbrooke's Cognitive Examination in Parkinson's Disease. Behav Neurol. 2018 Oct 2;2018:5932028.
Matias-Guiu JA, Fernandez de Bobadilla R, Escudero G, Perez-Perez J, Cortes A, Morenas-Rodriguez E, Valles-Salgado M, Moreno-Ramos T, Kulisevsky J, Matias-Guiu J. Validation of the Spanish version of Addenbrooke's Cognitive Examination III for diagnosing dementia. Neurologia. 2015 Nov-Dec;30(9):545-51. English, Spanish.
Reyes MA, Perez-Lloret S, Roldan Gerschcovich E, Martin ME, Leiguarda R, Merello M. Addenbrooke's Cognitive Examination validation in Parkinson's disease. Eur J Neurol. 2009 Jan;16(1):142-7.
Velayudhan L, Ryu SH, Raczek M, Philpot M, Lindesay J, Critchfield M, Livingston G. Review of brief cognitive tests for patients with suspected dementia. Int Psychogeriatr. 2014 Aug;26(8):1247-62.
Document last updated August 2022
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