ACE-R

Frequently asked questions

Why do I have to register to download the tests?

We would like to keep all users informed of any changes and updates on the
tests, normative data, and relevant papers. We are also interested in keeping
a register so that we can track how widely used the instrument has become.

Why are there 3 different versions (A, B and C)?

The versions differ in terms of the name and address recall task. They were
designed to avoid learning from one assessment to the next. Some patients
may learn the name and address over a couple of years follow-up, making the
test invalid.

When can I re-assess someone with the ACE-R?

Ideally only after 6 months (not earlier), to prevent patients from recalling
components for the test.

Can I make a dementia diagnosis based on the ACE-R score?

No. The ACE-R score should be only part of your clinical assessment, but
never used solely for a diagnosis. If your patient has a low score (e.g. below
cut-off), you might consider referring them for a thorough neuropsychological
assessment, or to a specialist if dementia/cognitive decline has not been
raised yet. It is important to remember that low scores can also be due to low

levels of education, cultural background differences or depression. Although,

in our experience, such factors rarely produce a score below 82.

Can I rate dementia (e.g. mild, moderate and severe) with an ACE-R
score?
No. Dementia ratings involve a comprehensive evaluation and should be
arrived at after via a thorough clinical assessment involving information from
caregivers and family members, and taking into account activities of daily
living. We are currently looking at its value in rating dementia severity across
different disorders.

Can any health professional give the ACE-R?

Yes. We recommend you to read the ACE-R guidelines, these frequently
asked questions, and to practise administration with a few controls (friend,
parent, grandparent, etc) to familiarise yourself with the test.

Do I need to pay to use the ACE-R?

No. Prof John Hodges holds the ACE-R copyright, but welcomes everyone to
use it for clinical and research purposes.

Are there normative data for patients above 75?

Not at the moment. Our collaborators are currently collecting extended
normative data, and we will update all registered users once the norms are
established.

Can I validate the ACE-R in my country?

If your language/country is not listed in our website, please contact us to get
some background information and authorisation to translate and validate the
test.

Can I ask for the name of the building where the

clinic/rehabilitation ward/outpatient service etc is based, instead of
floor?
Yes. Sometimes it does not make sense to ask for the floor, so a reasonable
adaptation is welcome. Just make sure your team asks the question in the
same way, and try to make notes of any changes you might have made for
follow-up re-assessments.
grfsaz
Which scores should I use for the VLOM ratio?
VLOM = Verbal fluency (max 14) + Language (max 26)/ Orientation (max 10)
+ Memory (max 7)
Orientation = only two first tasks
Memory = only recall of name and address at the end of the test

Can I apply the semantic index on the ACE-R?

Not directly. The analyses were done using the old ACE, so if you are
interested in using the index, you should complement the ACE-R with the
questions that make the semantic index to generate the scores you need.

I use the old ACE; should I change to the revised ACE (ACE-R)?
Ideally, yes. After years of use in Cambridge, John Hodges and his team
identified many weaknesses on the test, and the revised version was
produced and validated.

What are the key references on the use of the ACE and ACE-R?
ACE
Mathuranath PS, Nestor PJ, Berrios GE, Rakowicz W, and Hodges JR. A brief
cognitive test battery to differentiate Alzheimers disease and frontotemporal
dementia, Neurology , vol 55, 2000, 1613-1620.

Dudas RB, Berrios GE, Hodges JR. The Addenbrookes Cognitive Examination
(ACE) in the differential diagnosis of early dementias versus affective
disorder, Am J Geriatr Pychiatry, vol 13 (3), March 2005, 218-226.

Galton CJ, Erzinclioglu S, Sahakian BJ, Antoun N, Hodges JR. A comparison of

the Addenbrokes Cognitive Examination (ACE), conventional
neuropsychologtical assessment, and simple MRI-based medial temporal lobe
evaluation in the early diagnosis of Alzheimers disease, Cog Beh Neurol, vol
18, number 3, September 2005, 144-150.

Bak TH, Rogers TT, Crawford LM, Hearn VC, Mathuranath PS, Hodges JR.
Cognitive bedside assessment in atypical parkinsonian syndromes, J Neurol

Neurosurg Psychiatry, vol 76, 2005, 420-422

Mathuranath PS, Cherian JP, Mathew R, George A, Alexander A, Sarma SP.

Mini Mental State Examination and the Addenbrookes Cognitive Examination:
effect of education and norms for a multicultural population, Neurology India,
vol 55, 2007, 106-110.

Davies RR, Dawson K, Mioshi E, Erzinclioglu S, Hodges JR. Differentiation of

semantic dementia and Alzheimers disease using the Addenbrookes
Cognitive Examination (ACE), International Journal of Geriatric

Psychiatry, vol 23, 2008, 370-375.

ACE-R
Mioshi E, Dawson K, Mitchell J, Arnold R, Hodges JR. The Addenbrookes
Cognitive Examination Revised (ACE-R): a brief cognitive test for dementia
screening, International Journal of Geriatric Psychiatry, vol 21, 2006,
1078-1085.