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Efficacy of the visual cognitive assessment test for mild cognitive impairment/mild dementia diagnosis: a
Jui-Hung Hsu1, Chien-Cheng Liu2,3,4, I-Wen Chen1
1Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
Background:
Mild cognitive impairment (MCI) is an intermediate stage between normal ageing and dementia. The early identification of MCI is important for timely intervention. The visual cognitive assessment test (VCAT) is a brief language-neutral screening tool for detecting MCI/mild dementia. This meta-analysis evaluated the diagnostic efficacy of the VCAT for MCI/mild dementia.
Methods:
Medline, Embase, Google Scholar, and Cochrane Library were searched from their inception until August 2023 to identify studies using VCAT to diagnose MCI/mild dementia. The primary outcome was to assess the diagnostic accuracy of the VCAT for detecting MCI/mild dementia through area under the receiver operating characteristic curve (AU-ROC) analysis. The secondary outcome was to explore the correlation between VCAT scores and MCI/mild dementia presence by comparing scores among patients with and without MCI/mild dementia. Pooled sensitivity, specificity, and area under the curve (AUC) were calculated.
Results:
Five studies with 1,446 older adults (mean age 64-68.3 years) were included. The percentage of participants with MCI/mild dementia versus controls ranged from 16.5% to 87% across studies. All studies were conducted in Asian populations, mostly Chinese, in Singapore and Malaysia. The pooled sensitivity was 80% [95% confidence interval (CI) 68%-88%] and the specificity was 75% (95% CI 68%-80%). The AU-ROCC was 0.77 (95% CI 0.73-0.81). Patients with MCI/mild dementia had lower VCAT scores than the controls (mean difference -6.85 points, p < 0.00001).
Conclusion:
VCAT demonstrated acceptable diagnostic accuracy in distinguishing MCI/mild dementia in cognitively normal older adults. As a language-neutral and culturally unbiased tool, the VCAT shows promise in detecting MCI/mild dementia. Further studies in non-Asian populations are required.
Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/, identifier: CRD42023453453.
Insights
The Visual Cognitive Assessment Test (VCAT) shows good accuracy in identifying mild cognitive impairment (MCI) and mild dementia in older adults. This language-neutral tool is promising for early detection of cognitive decline.
Area of Science:
- Gerontology
- Neuroscience
- Psychometry
Background:
- Mild cognitive impairment (MCI) represents a transitional stage between normal aging and dementia.
- Early identification of MCI is crucial for timely therapeutic interventions.
- The Visual Cognitive Assessment Test (VCAT) is a brief, language-neutral screening tool designed for detecting MCI and mild dementia.
Conclusions:
- The VCAT demonstrates acceptable diagnostic accuracy for distinguishing MCI/mild dementia in older adults.
- As a language-neutral and culturally unbiased tool, VCAT shows potential for widespread use in MCI/mild dementia detection.
- Further research is recommended to validate VCAT's performance in non-Asian populations.
