Validation of the language component of the Addenbrooke's Cognitive Examination - Revised (ACE-R) as a screening tool for aphasia in stroke patients

  • Gaber T
  • Parsons F
  • Gautam V
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AIM: Several tests are available for aphasia screening following stroke. However, some of them have shortcomings such as need of specialist knowledge, low sensitivity and/or specificity and lengthy administration time. Our study aims to evaluate the language component of the Addenbrooke's Cognitive Examination--Revised (ACE-R) as a screening tool for aphasia in stroke patients. METHODS: The language component of ACE-R was administered to consecutive patients admitted to a post-acute stroke unit. Patients who were medically unstable or had a significant history of sensory impairment or mental health issues were excluded. The test was administered by two junior doctors with basic training in ACE-R administration. Patients recruited were also assessed by an experienced speech and language therapist (SLT). The results of the two assessments were documented by a different member of the team and the SLT results were used as the benchmark to calculate the ACE-R language component sensitivity and specificity. RESULTS: Fifty-nine participants were recruited and 27 of them were women. The mean age was 72 (SD 11.9). Thirty-four participants had left and 11 right hemisphere stroke. Fourteen had bilateral affection. Six participants were left handed. A cut-off value of 22/26 of ACE-R language component showed 100% specificity and 83.1% sensitivity, while a cut-off value of 16/26 had 88.2% specificity and 100% sensitivity. CONCLUSION: Our results suggest that the language component of ACE-R has a satisfactory sensitivity and specificity compared with other screening tests used in strokes. It is easy to administer and free to use.

Author-supplied keywords

  • Addenbrooke's Cognitive Examination
  • Aphasia screening
  • Stroke

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  • Tarek A Z K Gaber

  • Faye Parsons

  • Vidushi Gautam

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