A-197 Utility of the Addenbrooke’s Cognitive Examination—Third Edition (ACE-III) to Predict Neuropsychological Test Performance in Older Adults Referred for Neurocognitive Evaluation

Abstract

Abstract Objective The ACE-III is a brief cognitive screener with high sensitivity and specificity in detecting neurocognitive disorders. We examined the utility of ACE-III subscale scores (Attention/Orientation, Memory, Fluency, Language, Visuospatial) to predict performance on expanded neuropsychological evaluation and detect diagnostic group differences. Data Selection 217 patients (Mag = 74.0, Medu = 15.78) with neurocognitive concerns completed the ACE-III followed by a comprehensive neuropsychological evaluation, including Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) Digit Span Backward (DSB), Trail Making Test Part B (TMT B), Boston Naming Test (BNT), Controlled Oral Word Association Test (COWAT), Category Fluency (Vegetables), Wechsler Memory Scale-IV (WMS-IV) Logical Memory (LM), and WAIS-IV Block Design (BD). Patients were diagnosed as having Normal Cognition (NC), Mild Cognitive Impairment (MCI), or Major Neurocognitive Disorder (MND) from clinical history and overall performance (67-NC, 105-MCI, 45-MND). Within-construct performances on comprehensive testing were regressed on ACE-III subscales. Group differences in ACE-III subscales and total scores were also examined. Data Synthesis Each ACE-III subscale score predicted within-construct performance on expanded testing with moderate-strong effects (p’s < .001): Attention/Orientation predictive of WAIS-IV DSB and TMT B; Memory predictive of WMS-IV LM immediate and delayed; Fluency predictive of COWAT and Category Fluency; Language predictive of BNT; Visuospatial predictive of WAIS-IV BD. ACE-III subscale and total scores also distinguished between groups (NC > MCI > MND; p’s < .001). Conclusions Across severity of cognitive impairment, ACE-III subscales are predictive of within-construct performance on expanded testing. The ACE-III may be a useful proxy for a comprehensive neuropsychological evaluation and demonstrates diagnostic utility in distinguishing different levels of cognitive impairment in older adults referred for neurocognitive concerns.