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Brazilian Version of the Addenbrooke Cognitive Examination-revised in the Diagnosis of Mild Alzheimer Disease

Carvalho, Viviane Amaral MSc* †; Barbosa, Maira Tonidandel MD, PhD; Caramelli, Paulo MD, PhD* †

Cognitive and Behavioral Neurology: March 2010 - Volume 23 - Issue 1 - p 8-13
doi: 10.1097/WNN.0b013e3181c5e2e5
Original Studies

Objective To investigate the accuracy of the Brazilian version of the Addenbrooke Cognitive Examination-revised (ACE-R) in the diagnosis of mild Alzheimer disease (AD).

Background The ACE-R is an accurate and brief cognitive battery for the detection of mild dementia, especially for the discrimination between AD and frontotemporal dementia.

Methods The battery was administered to 31 patients with mild AD and 62 age-matched and education-matched cognitively healthy controls. Both groups were selected using the Dementia Rating Scale and were submitted to the ACE-R. Depression was ruled out in both groups by the Cornell Scale for Depression in Dementia. The performance of patients and controls in the ACE-R was compared and receiver operator characteristic curve analysis was undertaken to ascertain the accuracy of the instrument for the diagnosis of mild AD.

Results The mean scores at the ACE-R were 63.10±10.22 points for patients with AD and 83.63±7.90 points for controls. The cut-off score <78 yielded high diagnostic accuracy (receiver operator characteristic area under the curve=0.947), with 100% sensitivity, 82.26% specificity, 73.8% positive predictive value, and 100% negative predictive value.

Conclusions The Brazilian version of the ACE-R displayed high diagnostic accuracy for the identification of mild AD in the studied sample.

*Postgraduate Program in Neurology, University of São Paulo School of Medicine, São Paulo (SP)

Behavioral and Cognitive Neurology Unit, Department of Internal Medicine, Faculty of Medicine of the Federal University of Minas Gerais

Geriatric Unit, Faculty of Medical Sciences and Mater Dei Hospital, Belo Horizonte (MG), Brazil

No funding was received for this work.

Reprints: Paulo Caramelli, MD, PhD, Associate Professor of Neurology, Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Av. Prof. Alfredo Balena 190-Room 236, 30130-100, Belo Horizonte (MG), Brazil (e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.