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Background: The Addenbrooke's Cognitive Examination-Revised (ACE-R) is an accessible cognitive tool that supports the early detection of mild cognitive impairment (MCI), Alzheimer's disease (AD), and behavioral variant frontotemporal dementia (bvFTD)., Objective: To investigate the diagnostic efficacy of the ACE-R in MCI, AD, and bvFTD through the identification of novel coefficients for differentiation between these diseases., Methods: We assessed 387 individuals: 102 mild AD, 37 mild bvFTD, 87 with amnestic MCI patients, and 161 cognitively unimpaired controls. The Mokken scaling technique facilitated the extraction out of the 26 ACE-R items that exhibited a common latent trait, thereby generating the Mokken scales for the AD group and the MCI group. Subsequently, we performed logistic regression, integrating each Mokken scales with sociodemographic factors, to differentiate between AD and bvFTD, as well as between AD or MCI and control groups. Ultimately, the Receiver Operating Characteristic curve analysis was employed to assess the efficacy of the coefficient's discrimination., Results: The AD-specific Mokken scale (AD-MokACE-R) versus bvFTD exhibited an Area Under the Curve (AUC) of 0.922 (88% sensitivity and specificity). The AD-MokACE-R versus controls achieved an AUC of 0.968 (93% sensitivity, 94% specificity). The MCI-specific scale (MCI-MokACE-R) versus controls demonstrated an AUC of 0.859 (78% sensitivity, 79% specificity)., Conclusions: The ACE-R's capacity is enhanced through statistical methods and demographic integration, allowing for accurate differentiation between AD and bvFTD, as well as between MCI and controls. This new method not only reinforces its clinical value in early diagnosis but also surpasses traditional approaches noted in prior studies.

Background and Objectives: There is little evidence in the literature about the possible relationship between sarcopenia and cognition in older adults. Our objective was to investigate the association between cognitive impairment and sarcopenia in older adults living in the community through a systematic review of published studies., Research Design and Methods: We performed a systematic review with meta-analysis through Pubmed, LILACS, Scielo and Web of Science databases between March 1, 2001 and December 18, 2018. We included longitudinal and cross-sectional studies that evaluated sarcopenia and cognition as a primary objective., Results: Of the 274 studies identified by the systematic review, 10 were included in qualitative analysis (total of 9,703 participants), and 6 were eligible for the meta-analysis (n = 7,045). Mean prevalence of sarcopenia was 10.5%. Cognitive impairment was observed in 269 participants with sarcopenia (40%), compared with 1,616 in non-sarcopenic participants (25.3%). Sarcopenia was significantly associated with cognitive impairment (pooled OR = 2.50, 95% CI = 1.26-4.92; p = 0.008). Heterogeneity across the studies was high and significant (I² = 84%). Discussion and Implications: Our analyzes confirmed that sarcopenic older adults presented a higher prevalence of cognitive impairment. Sarcopenia may represent a risk factor for cognitive decline, but longitudinal studies are needed to explore causality., Competing Interests: The authors have no conflict of interest to report.