Improved Clinical Criteria for Diagnosing Vascular Cognitive Disorders


Improved Clinical Criteria for Diagnosing Vascular Cognitive Disorders

Improved Clinical Criteria for Diagnosing Vascular Cognitive Disorders

Researchers at UNSW Sydney’s Centre for Healthy Brain Ageing (CHeBA) have investigated how certain criteria for identifying cases of vascular cognitive disorders compare, as well as how well they predict a change from mild impairment to dementia within five years.

Vascular cognitive disorders include vascular dementia and milder forms of cognitive impairment caused by problems with blood flow to the brain, often as a result of stroke, and the conceptualisation of vascular cognitive disorders has evolved significantly since the description of multi-infarct dementia in the 1970s. Previous criteria for diagnosing vascular cognitive disorders have focused only on dementia, and often did not provide clear guidelines for clinical decision making.

Lead author on the paper and Co-Director of the Centre for Healthy Brain Ageing (CHeBA), Professor Perminder Sachdev said that other recent sets of criteria include DSM-5 and VICCCS; both of which have been widely used for clinical practice and research.”

“These criteria have limitations,” said Professor Sachdev.

“Among other reasons, they emphasise dementia and exclude milder impairments, disregarding that early recognition of vascular cognitive impairment is important for prevention. Also, having memory impairment as a necessary criterion for diagnosis of dementia biases the diagnosis towards Alzheimer’s disease,” he said.

To overcome some of these limitations the VASCOG criteria were developed.

“We investigated how VASCOG criteria compared with other criteria at identifying cases of vascular cognitive disorders, as well as how well they predict a change from mild impairment to dementia within five years, or mortality over 10 years,” said co-author on the paper Dr Darren Lipnicki.

The findings, published in the European Journal of Neurology, showed that VASCOG criteria compare well in performance with other current criteria and predict mortality better than previous criteria.

“With detailed guidelines for accurately diagnosing vascular cognitive disorders, VASCOG criteria are appropriate for both clinical use and research application,” said Professor Sachdev.

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