Addenbrooke's Cognitive Examination III (ACE-III) and Mini-ACE for the Detection of Dementia and Mild Cognitive Impairment

Cochrane Database of Systematic Reviews

Beishon, L. C., Batterham, A. P., et al. (2019).

Cochrane Database of Systematic Reviews, 12, CD013282.

This systematic review investigates the diagnostic test accuracy of the Addenbrooke's Cognitive Examination-III (ACE-III) and the mini-ACE for screening cognition in individuals with dementia or mild cognitive impairment (MCI).

The Cochrane Collaboration

Database inception to February 13, 2019

Cross-sectional studies; comparative studies; nested case control studies

7

For individuals experiencing cognitive decline, the ACE-III and the mini-ACE demonstrated good sensitivity and highly variable specificity for identifying cognitive characteristics indicative of dementia. For the ACE-III, one study using 88 as the cutoff threshold score reported sensitivity of 97% (95% CI: 84% to 100%) and specificity of 50% (95% CI: 30% to 70%), and two studies using 82 as the cutoff threshold score reported sensitivity of 82% (95% CI: 65% to 93%) and specificity of 77% (95% CI: 56% to 91%). For the mini-ACE, two studies using a threshold of 25 to detect dementia reported sensitivity ranging from 96% to 99% and specificity ranging from 32% to 85%. The authors of this review conclude, "overall, there is insufficient information in terms of both quality and quantity to recommend the use of either the ACE-III or mini-ACE for the detection of dementia in patients presenting with cognitive decline or in high-risk groups" (p. 19).

For individuals experiencing cognitive decline, the ACE-III and the mini-ACE demonstrated good sensitivity and highly variable specificity for identifying cognitive characteristics indicative of MCI. For the ACE-III, two studies using the cutoff threshold score of 88 reported sensitivity ranging from 75% to 77% and specificity ranging from 89% to 92%. For the mini-ACE, three studies using a threshold of 25 to detect MCI reported sensitivity ranging from 88% to 95% and specificity ranging from 46% to 72%, and one study using a threshold of 21 to detect MCI reported sensitivity of 64% and specificity of 79%. The authors of this review conclude that further research is needed on the use of the ACE-III and mini-ACE as a screening tool for MCI.