The Addenbrooke cognitive examination (ACE) detects cognitive impairment in advanced Parkinson?s disease but not in early Parkinson?s disease

ANABEL CHADE; MARÍA ROCA; TERESA TORRALVA; EZEQUIEL GLEICHGERRCHT; NICOLAS FABBRO; GONZALO GOMEZ AREVALO; OSCAR GERSHANIK; FACUNDO MANES

Buenos Aires

Congreso; International Congress of Parkinson's Disease and Movement Disorders; 2010

The International Parkinson and Movement Disorder Society (MDS)

Objective: To determine if the Spanish version of the ACE is capable of detecting cognitive difficulties in patients with early PD and in advanced PD. Background: Detecting cognitive impairment in patients with Parkinson´s Disease (PD) is crucial for good clinical practice given the new therapeutic possibilities available. The gold standard for detecting cognitive impairment in advanced PD patients is the Mattis Dementia Rating Scale and the neuropsychological testing in early PD but these tests are time-consuming and there is a need for a brief test for detecting cognitive deficit in early PD. The ACE is a practical, brief screening test that has been shown to be useful for the detection of dementia. Methods: We compared the ACE scores in 32 consecutive patients with early PD and 25 patients with advanced PD. All patients were in the on state at the time of assessment. Results: Early PD, 20 (62 %) were men, mean age (63, 15 ± 10.09 years), advanced PD patients 60 % were men, mean age (73 ±7.46 years). In the early PD, 25.6 % of patients showed no cognitive deficits on any of the classical neuropsychological tests. Forty one percent of patients exhibited deficit in one or two tests of the battery and 33.4 % presented deficits in three or more tests. Although 74.4 % of the patients had deficits in one or more test of the standard neuropsychological testing, the percentage of subjects scoring below the cut-off of 83/100 of the ACE (suggested to detect mild cognitive impairment) was lower on the early PD group (16 %) than on the advanced PD group (42.3 %) of patients. Conclusion: This study shows that the Spanish version of the ACE is capable of detecting patients with cognitive impairment in advanced PD but it is not an effective screening tool for early PD patients.