Toward Inclusive Screening of Cognitive Impairment: Validating the Visual Cognitive Assessment Test Among U.S.-Based...

Area of Science:

• Neuroscience
• Gerontology
• Cognitive Psychology

Background:

• Alzheimer's disease (AD) disproportionately affects Black/African American and Latino populations.
• Underrepresentation in AD research stems from biases in traditional cognitive assessments like the Montreal Cognitive Assessment (MoCA).
• Culturally neutral assessments are needed to improve inclusivity in AD research and clinical practice.

Purpose of the Study:

• To evaluate the Visual-based Cognitive Assessment Test (VCAT) as a culturally unbiased alternative to MoCA.
• To assess VCAT's comparability with MoCA in diverse populations.
• To examine the association between VCAT scores and plasma p-tau217, a biomarker for AD pathology.

Main Methods:

• A cross-sectional study involving 56 ethnoracially diverse individuals with normal cognition (NC), mild cognitive impairment (MCI), or dementia.
• Cognitive performance was assessed using both VCAT and MoCA.
• Linear regression models were used to analyze cognitive scores and their association with plasma p-tau217 levels in a subset of participants.

Main Results:

• VCAT scores demonstrated comparability to MoCA across all diagnostic groups (NC, MCI, dementia).
• Both VCAT and MoCA scores differed significantly across diagnostic groups, with higher scores in NC and lower scores in dementia.
• Plasma p-tau217 showed a significant inverse correlation with both VCAT and MoCA scores in individuals with dementia.

Conclusions:

• VCAT aligns strongly with MoCA, offering a culturally sensitive alternative for cognitive assessment.
• VCAT's correlation with plasma p-tau217 suggests its potential utility in reflecting underlying Alzheimer's disease pathology.
• VCAT shows promise for enhancing inclusivity and accuracy in both clinical settings and research for Alzheimer's disease.