title: The validity of the Addenbrooke's Cognitive Examination-Revised (ACE-R) in acute stroke.
abstract: OBJECTIVE
  The purpose was to examine the validity of the Addenbrooke's Cognitive Examination Revised (ACE-R) as a screening measure to detect cognitive impairment after stroke.
  
  
  METHODS
  Stroke patients in hospital were recruited and the ACE-R, which includes the Mini-Mental Status Examination (MMSE), was administered, followed by a battery of neuropsychological tests, which served as the 'gold standard' for classification of cognitive impairment. The diagnostic validity of the ACE-R was determined by ROC analysis.
  
  
  RESULTS
  Of the 101 patients who completed the ACE-R, 61 also completed the neuropsychological assessment. Both the MMSE and the ACE-R were found to have inadequate diagnostic validity for the detection of overall cognitive impairment (MMSE AUC = 0.53, p > 0.05; ACE-R AUC = 0.53, p > 0.05). The ACE-R subscales predicted impairment in specific cognitive domains significantly better than chance; Visuospatial (AUC = 0.71, p < 0.05), Fluency (AUC = 0.72, p< 0.05) and Attention and Orientation (AUC = 0.80, p < 0.05). However, no cut-off score for any subscale gave both adequate levels of sensitivity and specificity for the detection of impairment in specific areas of cognitive functioning.
  
  
  CONCLUSIONS
  The ACE-R was not a suitable measure to screen for overall cognitive impairment in acute stroke patients, but was able to detect impairment in visuospatial, attention and executive domains.
authors.affiliation: University of Lincoln, Lincoln, United Kingdom.
authors.forename: Katie
authors.initials: K
authors.lastname: Morris
authors.forename: Vicki
authors.initials: V
authors.lastname: Hacker
authors.forename: Nadina Berrice
authors.initials: NB
authors.lastname: Lincoln
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D015203:Reproducibility of Results; D020521:Stroke / Q000150:complications / Q000523:psychology*