Article

The purpose was to examine the validity of the Addenbrooke's Cognitive
Examination Revised (ACE-R) as a screening measure to detect cognitive impairment
after stroke. METHODS: Stroke patients in hospital were recruited and the ACE-R,
which includes the Mini-Mental Status Examination (MMSE), was administered,
followed by a battery of neuropsychological tests, which served as the 'gold
standard' for classification of cognitive impairment. The diagnostic validity of
the ACE-R was determined by ROC analysis. RESULTS: Of the 101 patients who
completed the ACE-R, 61 also completed the neuropsychological assessment. Both
the MMSE and the ACE-R were found to have inadequate diagnostic validity for the
detection of overall cognitive impairment (MMSE AUC = 0.53, p > 0.05; ACE-R AUC =
0.53, p > 0.05). The ACE-R subscales predicted impairment in specific cognitive
domains significantly better than chance; Visuospatial (AUC = 0.71, p < 0.05),
Fluency (AUC = 0.72, p< 0.05) and Attention and Orientation (AUC = 0.80, p <
0.05). However, no cut-off score for any subscale gave both adequate levels of
sensitivity and specificity for the detection of impairment in specific areas of
cognitive functioning. CONCLUSIONS: The ACE-R was not a suitable measure to
screen for overall cognitive impairment in acute stroke patients, but was able to
detect impairment in visuospatial, attention and executive domains.

Langue : ANGLAIS