An investigation into the use of the Addenbrooke's Cognitive Examination -Revised (ACE-R) as a means of predicting rehabilitation outcomes in adults aged 16 or over

Lennie, Susan (2012) An investigation into the use of the Addenbrooke's Cognitive Examination -Revised (ACE-R) as a means of predicting rehabilitation outcomes in adults aged 16 or over. D Clin Psy thesis, University of Glasgow.

Abstract

Objectives: To investigate (1) the use of the ACE-R in predicting functional gain during inpatient rehabilitation, and (2) whether ACE-R scores identify patients who will require additional therapy support during their rehabilitation.
Design: Prospective cohort study.
Setting: UK inpatient physically disabled rehabilitation unit.
Participants: Of the 100 adult participants approached, 65 had baseline assessments. Complete data sets were available for 60 (92.3%) participants and included for analysis. Mean age was 49.847 yrs (SD=12.01.
Main Outcome measures: Functional gain during rehabilitation was measured using the Functional Independence Measure (FIM). To control for baseline ability, the FIM change (FIM Discharge – FIM admission) was used as the main outcome measure.
Results: There were no significant correlations between ACE-R total (rho=.104, P=0.43), Memory (rho=.02, p=0.89) or Fluency (rho=.15, p=0.25) scores and FIM change. There were no significant correlations between FIM change and MMSE, mood, age, medical co-morbidities, number of medications, medication type, gender, continence and catheterisation, or social deprivation. There was a significant difference in the ACE-R Total (p<0.014), Memory (p=0.039) and Fluency (p=0.012) scores between those who did and did not require additional therapy support. A significant difference was also found between men and women in their ACE-R scores and need for additional support. Only ACE-R fluency and gender survived Logistic Regression Analysis.
Conclusion: ACE-R scores were not predictive of FIM change scores. The tool appeared more sensitive in identifying patients who required additional support with ACE-R fluency and gender appearing to be independent predictors. The study may have been underpowered to detect significant associations.

• Item Type: Thesis (D Clin Psy)
• Qualification Level: Doctoral
• Keywords: ACE-R, cognition, rehabilitation, predictor
• Subjects: B Philosophy. Psychology. Religion > BF Psychology
• Colleges/Schools: College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing
• Supervisor's Name: Evans, Professor Jon
• Date of Award: 2012
• Depositing User: Miss Susan Lennie
• Unique ID: glathesis:2012-3658
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 19 Nov 2012
• Last Modified: 10 Dec 2012 14:09
• URI: http://theses.gla.ac.uk/id/eprint/3658