Application of Addenbrooke’s Cognitive Examination to Diagnosis and Monitoring of Progressive Primary Aphasia

Abstract

Background/Aims: Primary progressive aphasia (PPA) comprises 2 main variants: semantic dementia (SD) and progressive nonfluent aphasia (PNFA). Addenbrooke’s Cognitive Examination (ACE) has become widely used for the diagnosis of dementias. Less information, however, is available about its ability to detect and monitor changes in cognition in PPA. We aimed to analyse the sensitivity and longitudinal changes of ACE scores in 2 subforms of PPA. Methods: We included 63 SD and 45 PNFA cases, all of whom had at least 2 assessments. Sensitivity levels, annualised rates of change and difference in scores over time on repeated ACE measurements were calculated. Results: A cut-off of 88 points detected 95% of the PNFA and SD cases. Longitudinal analysis showed an average annual decline of 10 points per year, with no significant difference between groups. Conclusion: The ACE is a useful tool for detecting and tracking the evolution of PPA.