title: The Utility of the Mini-Addenbrooke's Cognitive Examination as a Screen for Cognitive Impairment in Elderly Patients with Chronic Kidney Disease and Diabetes.
abstract: OBJECTIVE
  We tested the utility of the Mini-Addenbrooke's Cognitive Examination (M-ACE) in a cohort of older adults with chronic kidney disease (CKD) and diabetes.
  
  
  METHODS
  The M-ACE was administered to 112 CKD and diabetes patients attending a nephrology clinic. Cognitive impairment was based upon patient, informant, and case review, neuropsychological assessment, and application of criteria for mild cognitive impairment (MCI) and the Diagnostic and Statistical Manual of Mental Disorders, fifth edition for dementia. The M-ACE was also compared to the Mini-Mental State Examination (MMSE).
  
  
  RESULTS
  Upon assessment, 52 patients had normal cognitive function, 33 had MCI, and 27 had dementia. The area under the receiver operating curve for the M-ACE was 0.96 (95% CI 0.95-1.00). The sensitivity and specificity for a dementia diagnosis were 0.96 and 0.84 at the cut point <25 and 0.70 and 1.00 at the cut point <21. Mean M-ACE scores differed significantly between normal, demented, and MCI groups (p< 0.001), and compared to the MMSE, the M-ACE did not suffer from ceiling effects.
  
  
  CONCLUSIONS
  The M-ACE is an easily administered test with good sensitivity and specificity to capture and assist in the diagnosis of MCI or dementia in patients with CKD and diabetes.
authors.affiliation: Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, NHS Wales, Bodelwyddan, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Hobson
authors.affiliation: Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, NHS Wales, Bodelwyddan, UK; Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
authors.forename: Kamel H
authors.initials: KH
authors.lastname: Rohoma
authors.affiliation: Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, NHS Wales, Bodelwyddan, UK.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Wong
authors.affiliation: Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, NHS Wales, Bodelwyddan, UK.
authors.forename: Mick J
authors.initials: MJ
authors.lastname: Kumwenda
keywords: Chronic kidney disease; Diabetes; Mild cognitive impairment; Mini-Addenbrooke's Cognitive Examination; Screening for cognitive impairment