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Title: Development and validation of the 'Addenbrooke's Cognitive Examination' as a screening test for mild cognitive impairment in hearing impaired individuals
Author: North, Courtney
ISNI:       0000 0005 0288 4468
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2020
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Background: Despite high comorbidity of age-related hearing loss in individuals with mild cognitive impairment (MCI), current tests are inadequate to screen for MCI in hearing-impaired populations. Objectives: To develop a hearing-impaired version of the Addenbrooke’s Cognitive Examination (HI-ACE-III) and assess whether it can be used as a screening tool for mild cognitive impairment (MCI), and accurately distinguish cognitively impaired people from healthy controls. Method: In consultation with specialist neuropsychologists and older adults, the HI-ACE-III was developed by converting verbal instructions into a timed, visual PowerPoint (Microsoft Corp.) presentation. Two groups of subjects over the age of 60 were recruited; 29 had MCI and 30 were healthy controls. The HI-ACE-III was administered to both groups in order to establish diagnostic accuracy. the Rey-Osterrieth Complex Figure (ROFC), Spatial Span (SS) and Graded Naming Test (GNT), which are established non-hearing dependent measures, were also administered to assess convergent and divergent validity, Results: A Receiver Operating Characteristic (ROC) analysis revealed an Area Under the Curve (AUC) of 0.856, achieving reasonable sensitivity (75.9%) and good specificity (86.7%) at an optimum cut-off of <92. All HI-ACE-III subtests shared statistically significant correlations with the other measures of cognitive functioning. Internal consistency of the HI-ACE-III was verified with Cronbach’s alpha (α = .819). Conclusions: The results indicate that the HI-ACE-III is a sensitive and specific screening tool, with a good ability to diagnose patients with and without MCI. It is an easy to use adaptation of an already familiar tool, which clinicians who screen for MCI in hearing impaired groups, could use to promptly identify individuals who might benefit from more extensive neuropsychological investigation.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available