Validity of the Addenbrooke’s cognitive examination test (ACE-III) in identifying mild cognitive impairment and dementia in Lithuanian population

Introduction. Early detection of cognitive problems is becoming increasingly relevant for timely interventions and improvement of the quality of life of those affected. One of the most used cognitive assessment instruments is Addenbrooke’s cognitive examination test (ACE-III), which assesses five cognitive domains: attention, memory, verbal fluency, language, and visuospatial abilities. To expand the practical application of this test in Lithuanian clinical practice, it is important to evaluate its validity in recognizing mild cognitive impairment and dementia. Methods. The study involved healthy individuals as the control group (N = 309) and individuals with a diagnosis of mild cognitive impairment or dementia (N = 106). The age of the subjects ranged from 40 to 98 years. The study was conducted by meeting each person individually. The demographic data of the subject were collected, and the ACE-III and MMSE-2 tests were administered. Results. The optimal cut-off value of the ACE-III for dementia screening is 76 points, this cut-off value was characterized by 93.0% sensitivity and 95.8% specificity, and for mild cognitive impairment screening was 86 points, with 87.8% sensitivity and 81.2% specificity. Age (F(3.411) = 52.62, p < 0.001, η² = 0.278) and education (F(2.410) = 38.57, p < 0.001, η² = 0.158) were significantly associated with the results – younger and more educated people have had higher scores. It was noted that men scored slightly higher scores than women, and the differences between genders were statistically significant in all domains, except for verbal fluency domain (p = 0.249). The ACE-III score was characterized by a strong positive correlation with the MMSE-2 score (Pearson’s correlation r = 0.912, p < 0.001). Conclusions. ACE-III scores decrease with increasing cognitive impairment. Age, education, and gender are associated with ACE-III scores. The ACE-III is a valid and sensitive tool for screening for both mild cognitive impairment and dementia.