ACE-III — MRCPsych Paper B MCQ

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ModerateOld Age PsychiatryACE-IIIMRCPsych Paper B

During a memory-clinic assessment, a patient obtains the following domain scores: attention 15/18, memory 18/26, verbal fluency 10/14, language 22/26 and visuospatial abilities 13/16, giving a total score of 78/100. Which cognitive assessment has been administered?

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Correct answer: D — ACE-III

The correct answer is ACE-III. It is a 100-point cognitive assessment with separate scores for attention (18), memory (26), verbal fluency (14), language (26) and visuospatial abilities (16). These domain maxima and the total score uniquely identify it. The MMSE and MoCA are 30-point instruments, while the Clock Drawing Test assesses a narrower visuospatial and executive task. RUDAS is a brief multicultural cognitive screen with a different scoring structure. The original claim that ACE-III is simply “more sensitive than MMSE,” particularly for mild cognitive impairment, was removed because diagnostic performance depends on the population and threshold used. Cognitive scores must also be interpreted alongside history, functioning, mental state and assessment of reversible causes.

Reference: NHS England, Dementia Revealed: What Primary Care Needs to Know, section 'Assessing cognition', 2014, https://www.england.nhs.uk/wp-content/uploads/2014/09/dementia-revealed-toolkit.pdf