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Adaption and Preliminary Validation of the Addenbrooke’s Cognitive Examination‐III as a Screening Test for Mild Cognitive Impairment and Dementia in Hearing‐Impaired Individuals

North, C; Heatley, MH; Utoomprurkporn, N; Bamiou, DE; Costafreda, SG; Stott, J; (2021) Adaption and Preliminary Validation of the Addenbrooke’s Cognitive Examination‐III as a Screening Test for Mild Cognitive Impairment and Dementia in Hearing‐Impaired Individuals. European Journal of Neurology , 28 (6) pp. 1820-1828. 10.1111/ene.14753. Green open access

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Abstract

Background: A large proportion of older adults assessed for cognitive impairment likely have hearing loss, potentially affecting accuracy of cognitive performance estimations. This study aimed to develop a hearing‐impaired version of the Addenbrooke’s Cognitive Examination‐III (HI‐ACE‐III) and to assess whether the HI‐ACE‐III can accurately distinguish people with Mild Cognitive Impairment (MCI) and dementia from cognitively intact controls. / Methods: The HI‐ACE‐III was developed by converting verbal instructions into a visual, timed PowerPoint presentation. 74 participants over the age of 60 were classified into three groups: 29 had MCI, 15 had mild to moderate dementia and 30 cognitively intact controls. Receiver Operating Characteristic (ROC) curves were graphed to test screening accuracy. Concurrent validity was examined through correlations between HI‐ACE‐III domain scores and relevant, visually presented standardised neuropsychological measures. / Results: ROC analysis for dementia revealed an Area Under the Curve (AUC) of 0.99, achieving excellent sensitivity (100%) and good specificity (93.3%) at an optimum cut‐off of <87. The AUC for MCI was 0.86, achieving reasonable sensitivity (75.9%) and good specificity (86.7%) at an optimum cut‐off of <92. HI‐ACE‐III subtests shared anticipated and statistically significant correlations with established measures of cognitive functioning. Internal consistency of the HI‐ACE‐III was excellent as verified with Cronbach’s alpha (α = .904). / Conclusion: Preliminarily, the HI‐ACE‐III showed good reliability, validity and screening utility for MCI and dementia in older adults in a hearing‐impairment context. The adapted HI‐ACE‐III may offer accurate and reliable indication of cognitive performance, supporting timely diagnosis and research examining links between hearing loss and cognitive decline.

Type: Article
Title: Adaption and Preliminary Validation of the Addenbrooke’s Cognitive Examination‐III as a Screening Test for Mild Cognitive Impairment and Dementia in Hearing‐Impaired Individuals
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/ene.14753
Publisher version: https://doi.org/10.1111/ene.14753
Language: English
Additional information: © 2021 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > The Ear Institute
URI: https://discovery.ucl.ac.uk/id/eprint/10120520
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