Dataset Information

Addenbrooke's cognitive examination III: diagnostic utility for detecting mild cognitive impairment and dementia in Parkinson's disease.

ABSTRACT:

Background

Cognitive deficit in Parkinson disease (PD) is an important cause of functional disability in these patients and early detection, with sensitive instruments, can contribute to longitudinal monitoring.

Objective

To investigate the diagnostic accuracy, sensitivity, and specificity of the Addenbrooke's Cognitive Examination-III in patients with PD, using the comprehensive neuropsychological battery as reference method.

Methods

Cross-sectional, observational, case-control study.

Setting

rehabilitation service. A total of 150 patients and 60 healthy controls matched for age, sex, and education. For level I assessment, Addenbrooke Cognitive Examination (ACE-III) was used. Level II assessment used a comprehensive neuropsychological battery of standardized tests for this population. All patients remained in on-state during the study. The diagnostic accuracy of the battery was investigated through the receiver operating characteristic (ROC) analysis.

Results

The clinical group was divided into 3 subgroups: normal cognition in Parkinson's disease (NC-PD-16%), mild cognitive impairment due to Parkinson's disease (MCI-PD-69.33%), and dementia due to Parkinson's disease (D-PD-14.66%). ACE-III optimal cutoff scores for detecting MCI-PD and D-PD were 85/100 (sensitivity 58.65%, specificity 60%) and 81/100 points (sensitivity 77.27%, specificity 78.33%), respectively. Age was inversely associated with the performance of the scores (totals and domains of the ACE-III), while the level of education had a significantly positive correlation in the performance of these scores.

Conclusions

ACE-III is a useful battery for assessing the cognitive domains and to differentiate individuals with MCI-PD and D-PD from healthy controls. Future research, in a community setting, is necessary to provide discriminatory capacity of ACE-III in the different severities of dementia.

SUBMITTER: Sousa NMF

PROVIDER: S-EPMC10033197 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Publications

Addenbrooke's cognitive examination III: diagnostic utility for detecting mild cognitive impairment and dementia in Parkinson's disease.

Sousa Nariana Mattos Figueiredo NMF Brucki Sonia Maria Dozzi SMD

Arquivos de neuro-psiquiatria 20230201 2

<h4>Background</h4>Cognitive deficit in Parkinson disease (PD) is an important cause of functional disability in these patients and early detection, with sensitive instruments, can contribute to longitudinal monitoring.<h4>Objective</h4>To investigate the diagnostic accuracy, sensitivity, and specificity of the Addenbrooke's Cognitive Examination-III in patients with PD, using the comprehensive neuropsychological battery as reference method.<h4>Methods</h4>Cross-sectional, observational, case-co ...[more]

PMID: 36863401

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Project description:The Addenbrooke's Cognitive Examination III is a brief cognitive screening tool that is widely used for the detection and monitoring of dementia. Recent findings suggest that the three variants of primary progressive aphasia can be distinguished based on their distinct profiles on the five subdomain scores of this test. Here, we investigated the utility of the Addenbrooke's Cognitive Examination III to differentiate the primary progressive aphasia variants based on their item-by-item performance profiles on this test. From these results, we created an interactive primary progressive aphasia Addenbrooke's Cognitive Examination III calculator which predicts the variant based on a patient's unique item-by-item profile. Twenty-eight logopenic variant, 25 non-fluent variant and 37 semantic variant primary progressive aphasia patients and 104 healthy controls completed the Addenbrooke's Cognitive Examination III at first clinical presentation. Multinomial regression analyses were conducted to establish performance profiles among groups, and R Shiny from RStudio was used to create the interactive Addenbrooke's Cognitive Examination III diagnostic calculator. To verify its accuracy, probability values of the regression model were derived based on a 5-fold cross-validation of cases. The calculator's accuracy was then verified in an independent sample of 17 logopenic, 19 non-fluent and 13 semantic variant primary progressive aphasia patients and 68 Alzheimer's disease patients who had completed the Addenbrooke's Cognitive Examination III (or an older version of this test: Revised) and had in vivo amyloid-PET imaging and/or brain autopsy pathological confirmation. Cross-validation of cases in the calculator model revealed different rates of sensitivity in classifying variants: semantic = 100%, non-fluent = 80.6% and logopenic = 79.9%; healthy controls were distinguished from primary progressive aphasia patients with 100% sensitivity. Verification of in vivo amyloid and/or autopsy-confirmed patients showed that the calculator correctly classified 10/13 (77%) semantic variant, 3/19 (16%) non-fluent variant and 4/17 (24%) logopenic variant patients. Importantly, for patients who were not classified, diagnostic probability values mostly pointed toward the correct clinical diagnosis. Furthermore, misclassified diagnoses of the primary progressive aphasia cohort were rare (1/49; 2%). Although 22 of the 68 Alzheimer's disease patients (32%) were misclassified with primary progressive aphasia, 19/22 were misclassified with the logopenic variant (i.e. falling within the same neuropathological entity). The Addenbrooke's Cognitive Examination III primary progressive aphasia diagnostic calculator demonstrates sound accuracy in differentiating the variants based on an item-by-item Addenbrooke's Cognitive Examination III profile. This calculator represents a new frontier in using data-driven approaches to differentiate the primary progressive aphasia variants.

Dataset Information

Addenbrooke's cognitive examination III: diagnostic utility for detecting mild cognitive impairment and dementia in Parkinson's disease.

Background

Objective

Methods

Setting

Results

Conclusions

Publications

Addenbrooke's cognitive examination III: diagnostic utility for detecting mild cognitive impairment and dementia in Parkinson's disease.

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