Dementia diagnosis in seven languages: the Addenbrooke’s Cognitive Examination-III in India

Mekala, Shailaja, Paplikar, Avanthi, Mioshi, Eneida, Kaul, Subhash, Gollahalli, Divyaraj, Coughlan, Gillian, Ellajosyula, Ratnavalli, Jala, Sireesha, Menon, Ramshekhar N, Narayanan, Jwala, Narayan, Sunil, Aghoram, Rajeswari, Nehra, Ashima, Rajan, Amulya, Sabnis, Prerna, Singh, Sonia, Tripathi, Manjari, Verma, Mansi, Saru, Lekha V., Hodges, John R. and Alladi, Suvarna (2020) Dementia diagnosis in seven languages: the Addenbrooke’s Cognitive Examination-III in India. Archives of Clinical Neuropsychology. ISSN 1873-5843

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Abstract

Objective : With the rising burden of dementia globally, there is a need to harmonise dementia research across diverse populations. The Addenbrooke’s Cognitive Examination-III (ACE-III) is a well-established cognitive screening tool to diagnose dementia. But there have been few efforts to standardise the use of ACE-III across cohorts speaking different languages. The present study aimed to standardise and validate ACE-III across seven Indian languages and to assess the diagnostic accuracy of the test to detect dementia and mild cognitive impairment (MCI) in the context of language heterogeneity. Methods : The original ACE-III was adapted to Indian languages: Hindi, Telugu, Kannada, Malayalam, Urdu, Tamil, and Indian English by a multidisciplinary expert group. The ACE-III was standardised for use across all seven languages. 757 controls, 242 dementia, and 204 MCI patients were recruited across five cities in India for the validation study. Psychometric properties of adapted versions were examined, and their sensitivity and specificity were established. Results : The sensitivity and specificity of ACE-III in identifying dementia ranged from 0.90 to 1, and sensitivity for MCI ranged from 0.86 to 1 and specificity from 0.83 to 0.93. Education, but not language was found to have an independent effect on ACE-III scores. Optimum cut-off scores were established separately for low education (≤10 years of education) and high education (>10 years of education) groups. Examination of the ACE-III validity results on the new independent sample, show good diagnostic validity, indicating usefulness of the ACE-III as a diagnostic tool. Conclusions : The adapted versions of ACE-III have been standardised and validated for use across seven Indian languages, with high diagnostic accuracy in identifying dementia and MCI in a linguistically diverse context.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: LivePure Connector
Date Deposited: 13 Feb 2020 05:40
Last Modified: 30 Mar 2020 00:31
URI: https://ueaeprints.uea.ac.uk/id/eprint/74172
DOI: 10.1093/arclin/acaa013

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