An investigation into the reliability of the Addenbrooke’s Cognitive Examination-III (ACE-III) and clinical research portfolio

Thomson, Hollie (2020) An investigation into the reliability of the Addenbrooke’s Cognitive Examination-III (ACE-III) and clinical research portfolio. D Clin Psy thesis, University of Glasgow.

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Dementia is a leading cause of disability amongst older adults in the developed world. In recent years, an increasing emphasis has been placed on the early detection and diagnosis of dementia, and timely access to post-diagnostic support. Cognitive screening tests are essential tools in facilitating the process of early detection and dementia diagnosis and are currently widely used in clinical practice. The Addenbrooke’s Cognitive Examination-III (ACE-III) is one such tool. Despite it being recommended in several evidence-based guidelines and being widely used in the NHS, the rater reliability of the ACE-III has never been formally evaluated.

To investigate rater accuracy in scoring the ACE-III both in terms of its total and sub-category scores across different raters and by the same raters at two different time points. A secondary exploratory analysis examines whether scoring accuracy is affected by participants’ experience of using the ACE-III and/or whether they have had formal training on how to administer and score the ACE-III.

A filmed vignette of the ACE-III being administered to an older adult actor (mock patient) was used to assess scoring accuracy across different raters. The vignette has pre-determined ‘true’ scores. Participants were asked to view the filmed vignette whilst simultaneously completing an ACE-III scoring sheet. Following a two-month period, participants were invited back to view and score the same vignette again to assess intra-rater reliability. Participants were NHS staff working in Older People’s Community Mental Health Teams who routinely administer and score the ACE-III as part of their clinical practice.

Results and Conclusions:
The inter- and intra-rater scoring accuracy of the ACE-III is generally good, with error mainly accounted for by the domains which require more subjective judgements, namely, the visuospatial and language tests. Health professionals should therefore take these findings into account when scoring the ACE-III, and utilise the ACE-III administration and scoring guide to help improve accuracy. If all health professionals score the ACE-III in a consistent manner, the accurate and early identification and management of those individuals with a dementia will be improved.

Item Type: Thesis (D Clin Psy)
Qualification Level: Doctoral
Keywords: Dementia, cognitive screening tool, reliability.
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
Supervisor's Name: Evans, Professor Jonathan
Date of Award: 2020
Depositing User: Miss Hollie Thomson
Unique ID: glathesis:2020-81414
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 04 Jun 2020 15:10
Last Modified: 05 Oct 2022 15:54
Thesis DOI: 10.5525/gla.thesis.81414

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