1154 The utility of the Addenbrooke's Cognitive Examination-Revised (ACE-R) in Parkinson's disease
Bibliographic record
Abstract
Introduction Cognitive impairment is common in Parkinson9s disease (PD), even in the early stages, and appropriate screening tools which are suitable for use in the general neurology clinic are needed. Methods We investigated the utility of the Addenbrooke9s Cognitive Examination-Revised (ACE-R) as a tool for detecting mild cognitive impairment in PD (PD-MCI), defined using a detailed neuropsychological battery in an incident PD cohort. ACE-R was also validated against the Parkinson9s Disease Cognitive Rating Scale (PD-CRS). We investigated the relationship between ACE-R score and behaviour and day-to-day function using the Cambridge Behavioural Inventory—Revised (CBI-R) and Parkinson9s Disease Questionnaire-39 (PDQ-39). The ACE-R cognitive profile in non-demented PD was compared with profiles in of early cognitive impairment in Huntington9s disease (HD), Progressive Supranuclear Palsy (PSP), amnestic mild cognitive impairment (MCI) and Alzheimer9s Disease (AD). Results 27% of the incident PD cohort were defined as PD-MCI. ROC analysis revealed an AUC for the ACE-R of 0.89 (95% CI 0.81 to 0.96). An ACE-R cut-off of <89 gave specificity 91%, sensitivity 65%, whereas a cut-off of <94 gave a sensitivity of 92% and specificity 64%. ACE-R correlated well with PD-CRS (r=0.801, p<0.0001). Significant correlations were seen between the ACE-R and CBI-R (cc=−0.249, p=<0.0001), and PDQ-39 (cc=−0.246, p=<0.0001) following adjustment for age, disease duration, Unified Parkinson9s Disease Rating Scale (UPDRS) motor score and Beck Depression Inventory score (BDI). Across disease groups there was a significant difference between ACE-R profiles. Conclusion The ACE-R is a valid screening tool for mild cognitive impairment in PD and correlates with behavioural deficits and quality of life. Furthermore it is capable of distinguishing between the cognitive profile in non-demented PD and a range of other neurological conditions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".