Fax +41 61 306 12 34
E-Mail karger@karger.ch
www.karger.com
Original Research Article
Dement Geriatr Cogn Disord 2006;22:385–391
DOI: 10.1159/000095642
Validation of the Addenbrooke’s Cognitive
Examination for Detecting Early Alzheimer’s
Disease and Mild Vascular Dementia in a
German Population
P. Alexopoulos
a
B. Greim
b
K. Nadler
a
U. Martens
a
B. Krecklow
a
G. Domes
a
S. Herpertz
a
A. Kurz
c
a
Department of Psychiatry and Psychotherapy and
b
Department of Neurology, Zentrum für Nervenheilkunde,
Universität Rostock, Rostock, and
c
Department of Psychiatry and Psychotherapy, Technische Universität München,
München, Germany
fication of AD and VaD, assessing a broad range of cognitive
functions and providing a wide profile of cognitive func-
tions/dysfunctions. Copyright © 2006 S. Karger AG, Basel
Introduction
As a result of the rapidly aging population, the inci-
dence of age-related cognitive disorders substantially and
dramatically increases and constitutes a challenge to so-
cial, financial and health policy-makers. It is of great im-
portance to make an early diagnosis of dementia in order
to institute appropriate medical and social interventions.
Alzheimer’s disease (AD) and vascular dementia (VaD)
are the most common types of dementia [1, 2]. The diag-
nosis of dementia is based on the clinical assessment of
cognitive impairments and their impact on the activities
of daily living. Screening and diagnostic tests, providing
an objective measure of the cognitive performance, con-
tribute to the detection of dementia and support diagno-
sis. Ideally the tests for screening dementia should be sen-
sitive and specific enough to identify cognitive deficits,
quick to administer, easy to score and they should sample
a broad range of cognitive capacities and difficulty levels
[3, 4] .
Key Words
Alzheimer’s disease Vascular dementia German
population Addenbrooke’s Cognitive Examination
Mini-Mental State Examination
Abstract
We assessed the diagnostic accuracy of the German version
of the Addenbrooke’s Cognitive Examination (ACE) in iden-
tifying early Alzheimer’s disease (AD) and mild vascular de-
mentia (VaD) in comparison with the conventional Mini-
Mental State Examination (MMSE). The study refers to 50
patients with mild dementia of AD, 26 patients with mild de-
mentia of vascular etiology and to 54 cognitively normal
subjects. The ACE and MMSE were validated against an ex-
pert diagnosis based on a comprehensive diagnostic work-
up. Statistical analysis was performed using the receiver op-
erator characteristics method. The optimal cut-off score for
the ACE for detecting dementia in patients with early AD was
85/86, which had a sensitivity of 93% and a specificity of
86%. The optimal cut-off for the ACE for the identification of
dementia in patients with mild VaD was also 85/86 and it had
a sensitivity of 93% and a specificity of 100%. The values
imply a substantial agreement between the diagnoses made
by the ACE and the MMSE. The German version of the ACE is
a short and practical but accurate test battery for the identi-
Accepted: April 20, 2006
Published online: September 6, 2006
Dr. med. Panos Alexopoulos
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität Rostock
Gehlsheimer Strasse 20
DE–18147 Rostock (Germany)
Tel. +49 381 494 9501, Fax +49 381 494 9502, E-Mail palexopoulos@freemail.gr
© 2006 S. Karger AG, Basel
1420–8008/06/0226–0385$23.50/0
Accessible online at:
www.karger.com/dem