{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T08:57:28Z","timestamp":1791190648448,"version":"4.1.0"},"reference-count":38,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dement Geriatr Cogn Disord"],"abstract":"<jats:p>Introduction: Translating cognitive test results into clinically meaningful measures of dementia severity remains challenging in real-world settings, where biomarkers are limited and functional assessment may occasionally be confounded by noncognitive factors. Although the Addenbrooke\u2019s Cognitive Examination-III (ACE-III) is widely used for detecting Alzheimer\u2019s disease (AD), its role in severity staging is less established. This study evaluated the usefulness of ACE-III for functionally anchored staging and compared it with the Mini-Mental State Examination (MMSE). Methods: In a retrospective real-world cohort of 1,170 patients with AD dementia (late-onset, early onset, and mixed), severity was classified using the Functional Assessment Staging Tool (FAST). Receiver operating characteristic analyses were used to derive cut-offs for differentiating adjacent stages (FAST 4 vs. 5; FAST 5 vs. 6). Domain-level and subtype-specific analyses were conducted. Results: ACE-III showed excellent discrimination between FAST 4 and 5 (area under the ROC curve [AUC] = 0.92; cut-off \u226456) and moderate discrimination between FAST 5 and 6 (AUC = 0.77; cut-off \u226442), outperforming MMSE in later stages (AUC = 0.63). Attention contributed most to earlier transitions, whereas later stages showed broader domain involvement. Cut-offs varied across AD subtypes. Conclusion: ACE-III provides clinically meaningful estimates of dementia severity and may help overcome limitations of functional assessment in real-world settings, supporting its use for staging and monitoring in routine clinical practice.<\/jats:p>","DOI":"10.1159\/dem\/aciag001","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T13:02:49Z","timestamp":1786021369000},"page":"1-1","source":"Crossref","is-referenced-by-count":0,"title":["Functional Staging of Alzheimer\u2019s Disease Dementia with Addenbrooke Cognitive Examination-III: Evidence for Subtype-Specific Cognitive Thresholds"],"prefix":"10.1159","author":[{"given":"Anna","family":"Barczak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.14283\/jpad.2021.23"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.4088\/pcc.v08n0306"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13859"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(23)00447-7"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmed.2022.05.008"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1159\/000545907"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2025.1727738"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13164695"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1080\/13803395.2025.2596181"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12830"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1111\/jnp.12431"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1159\/000351671"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1159\/000439248"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.15557\/an.2017.0004"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s10433-021-00652-4"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph191912257"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1159\/000549856"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1111\/ene.70257"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1159\/000534313"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0251137"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1002\/gps.4570"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617718000541"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1192\/bjb.2023.27"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1017\/s1041610292001157"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(75)90026-6"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2011.03.005"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.5114\/ppn.2026.161371"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1177\/13872877251316801"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2025.40.e20"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0322572"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610218000704"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1159\/000478520"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610223000509"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1590\/1980-57642016dn11-040005"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.349605"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.14283\/jpad.2018.22"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0073645"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.14283\/jpad.2016.99"}],"container-title":["Dementia and Geriatric Cognitive Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/dem\/aciag001","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T08:47:27Z","timestamp":1791190047000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/dem\/aciag001"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":38,"URL":"https:\/\/doi.org\/10.1159\/dem\/aciag001","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.33104630","asserted-by":"subject"}]},"ISSN":["1420-8008","1421-9824"],"issn-type":[{"value":"1420-8008","type":"print"},{"value":"1421-9824","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]}}}