title: Validation of the revised Addenbrooke's Cognitive Examination (ACE-R) for detecting mild cognitive impairment and dementia in a Japanese population.
abstract: BACKGROUND
  Early detection of dementia will be important for implementation of disease-modifying treatments in the near future. We aimed to investigate the diagnostic validity and reliability of the Japanese version of the revised Addenbrooke's Cognitive Examination (ACE-R J) for identifying mild cognitive impairment (MCI) and dementia.
  
  
  METHODS
  We translated and adapted the original ACE-R for use with a Japanese population. Standard tests for evaluating cognitive decline and dementing disorders were applied. A total of 242 subjects (controls = 73, MCI = 39, dementia = 130) participated in this study.
  
  
  RESULTS
  The optimal cut-off scores of ACE-R J for detecting MCI and dementia were 88/89 (sensitivity 0.87, specificity 0.92) and 82/83 (sensitivity 0.99, specificity 0.99) respectively. ACE-R J was superior to the Mini-Mental State Examination in the detection of MCI (area under the curve (AUC): 0.952 vs. 0.868), while the accuracy of the two instruments did not differ significantly in identifying dementia (AUC: 0.999 vs. 0.993). The inter-rater reliability (ICC = 0.999), test-retest reliability (ICC = 0.883), and internal consistency (Cronbach's α = 0.903) of ACE-R J were excellent.
  
  
  CONCLUSIONS
  ACE-R J proved to be an accurate cognitive instrument for detecting MCI and mild dementia. Further neuropsychological evaluation is required for the differential diagnosis of dementia subtypes.
authors.affiliation: Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. hyoshida416@yahoo.co.jp
authors.forename: Hidenori
authors.initials: H
authors.lastname: Yoshida
authors.forename: Seishi
authors.initials: S
authors.lastname: Terada
authors.forename: Hajime
authors.initials: H
authors.lastname: Honda
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kishimoto
authors.forename: Naoya
authors.initials: N
authors.lastname: Takeda
authors.forename: Etsuko
authors.initials: E
authors.lastname: Oshima
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hirayama
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokota
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Uchitomi
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000175:diagnosis*; D003704:Dementia / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis; D009483:Neuropsychological Tests / Q000592:standards*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014175:Translating