The Vascular Behavioral and Cognitive Disorders criteria for vascular cognitive disorders: a validation study

Area of Science:

• Neurology
• Neuroscience
• Cognitive Science

Background:

• Vascular cognitive disorders (VCD) are a significant cause of cognitive decline.
• The Vascular Behavioral and Cognitive Disorders (VASCOG) criteria were introduced in 2014.
• The diagnostic validity of VASCOG criteria has not been previously assessed.

Purpose of the Study:

• To evaluate the concurrent and predictive validity of the VASCOG criteria for VCD.
• To compare VASCOG criteria with existing diagnostic standards for vascular dementia (VaD) and mild VCD (mVCD).

Main Methods:

• Analysis of data from 165 participants (aged 49-86) in the Sydney Stroke Study.
• Comparison of diagnoses made using VASCOG, DSM-5, VICCCS, NINDS-AIREN, ADDTC, and DSM-IV criteria.
• Assessment of agreement using Cohen's kappa (κ) and investigation of predictive validity for mortality and dementia.

Main Results:

• VASCOG criteria identified mild VCD (mVCD) at rates comparable to DSM-5 and VICCCS.
• Excellent agreement was found between VASCOG, VICCCS, and DSM-5 for VaD and mVCD (κ = 0.83-1.0).
• VaD diagnoses using VASCOG, VICCCS, and DSM-5 showed similar, higher predictive validity for mortality compared to older criteria.

Conclusions:

• VASCOG criteria demonstrate good sensitivity, modest concurrent validity, and strong predictive validity for vascular dementia.
• VASCOG criteria are comparable to DSM-5 and VICCCS, offering advantages in operationalization and inclusion of mild VCD.
• The VASCOG criteria are suitable for both clinical practice and research in vascular cognitive disorders.