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Journal of the Korean Neurological Association 2009;27(4): 345-354.
A Standardization Study on the Korean Version of the Addenbrook’s Cognitive Examination Revised (K-ACE) as a Cognitive Impairment Screening Instrument: Reliability, Validity and Normative Data
석승한, 전진수b 신강현c
원광대학교 의과대학 산본병원 신경과a, 원광대학교 안산시립노인전문병원 신경과b, 아주대학교 심리학과c
인지장애 선별을 위한 K-ACE 표준화 연구: 신뢰도, 타당도, 규준치 개발
Seung-Han Suk
Department of Neurologya, Wankwang University College of Medicine, Sanbon Medical Center, Gunpo, Korea Department of Neurologyb, Wonkwang University Ansan Municipal Geriatric Hospital, Ansan, Korea Department of Psychologyc, Ajou University, Suwon, Korea
Abstract
Background: Addenbrooke’s Cognitive Examination-Revised (ACE-R) is a brief but sensitive and specific test for screening cognitive impairment. The clinical need for brief, inexpensive, and sensitive cognitive screening tools is well acknowledged. The aims of this study were to develop a Korean version of the ACE-R (K-ACE) and to obtain normative data for community-dwelling, apparently healthy adults.
Methods: The ACE-R was translated and modified to produce the K-ACE. Some items that were considered less familiar to Koreans were replaced with “Korean-friendly” items. Back-translation was performed. The K-ACE was administered to 422 of 480 subjects who were recruited from stroke- and dementia-free adults living in Ansan-si, Gyeonggi-do, by systematic random sampling. The Korean version of the Short Blessed Test (SBT-K) was also completed by 85 of the subjects. We examined the internal consistency, reliability, and validity of the K-ACE. The influences of age, sex, and education level on K-ACE score were also evaluated.
Results: The internal consistency of the K-ACE was high (Cronbach’s alpha=0.854), and the test?retest and interrater reliability were also very good (coefficient=0.929 and 0.984, respectively). The validity of the K-ACE was high through correlations between K-ACE and K-MMSE (r=0.939, p<0.01) and SBT-K (r=-0.871, p<0.01). Male, younger, and highly educated subjects had higher K-ACE scores on univariate analysis. Age and education level, but not sex, were significantly correlated with the score on stepwise multiple regression analysis. Therefore, normative data relative to age and education level were obtained.
Conclusions: The K-ACE was found to be a brief, reliable, and valid screening test battery for cognitive dysfunction. We were able to determine the norms for the K-ACE for community-dwelling, middle-aged and elderly people. Key Words: Cognitive impairment, K-ACE, Reliability, Validity, Norm
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