Addenbrooke’s Cognitive Examination and Individual Domain Cut-Off Scores for Discriminating between Different Cognitive Subtypes of Parkinson’s Disease

Abstract EN

Objective.

The main aim of this study was to verify the sensitivity and specificity of Addenbrooke’s Cognitive Examination-Revised (ACE-R) in discriminating between Parkinson’s disease (PD) with normal cognition (PD-NC) and PD with mild cognitive impairment (PD-MCI) and between PD-MCI and PD with dementia (PD-D).

We also evaluated how ACE-R correlates with neuropsychological cognitive tests in PD.

Methods.

We examined three age-matched groups of PD patients diagnosed according to the Movement Disorder Society Task Force criteria: PD-NC, PD-MCI, and PD-D.

ROC analysis was used to establish specific cut-off scores of ACE-R and its domains.

Correlation analyses were performed between ACE-R and its subtests with relevant neuropsychological tests.

Results.

Statistically significant differences between groups were demonstrated in global ACE-R scores and subscores, except in the language domain.

ACE-R cut-off score of 88.5 points discriminated best between PD-MCI and PD-NC (sensitivity 0.68, specificity 0.91); ACE-R of 82.5 points distinguished best between PD-MCI and PD-D (sensitivity 0.70, specificity 0.73).

The verbal fluency domain of ACE-R demonstrated the best discrimination between PD-NC and PD-MCI (cut-off score 11.5; sensitivity 0.70, specificity 0.73) while the orientation/attention subscore was best between PD-MCI and PD-D (cut-off score 15.5; sensitivity 0.90, specificity 0.97).

ACE-R scores except for ACE-R language correlated with specific cognitive tests of interest.