JMIR Publications

ABSTRACT

Background:

Vascular Mild Cognitive Impairment (VMCI) is a significant global health concern, particularly in Asia. The Visual Cognitive Assessment Test (VCAT) has shown promise as a language-neutral screening tool for cognitive impairment.

Objective:

This study aimed to assess the effectiveness of the VCAT in detecting VMCI and to compare its diagnostic performance with the widely used and validated Montreal Cognitive Assessment (MoCA).

Methods:

Cross-sectional data from 524 community-dwelling participants was analysed from the Biomarkers and Cognition Study, Singapore (BIOCIS) and classified into Non-Vascular Cognitively Unimpaired (NVCU), Non-Vascular Mild Cognitive Impairment (NVMCI) and VMCI groups. Participants underwent neuropsychological assessments and 3T Magnetic Resonance Imaging (MRI). Random Forest technique and multivariable logistic regression were applied to assess the discriminative properties of tests.

Results:

VMCI participants exhibited significantly lower performance across various neuropsychological tests and higher rates of vascular risk factors. At a cut-off of 27, VCAT achieved near perfect accuracy in discriminating VMCI from NVCU (AUC = 1, Sensitivity = 1, Specificity = 0.991). For differentiating VMCI from NVMCI, both VCAT and MoCA showed optimal performance at a cut-off of 25 (AUC = 1.00, Sensitivity = 1.00, Specificity = 1.00).

Conclusions:

VCAT could be a valuable tool for detecting VMCI, particularly in diverse, multilingual populations. Its comparable or even superior performance to MoCA, combined with its language-neutral design, positions VCAT as a strong addition to cognitive assessment toolkits for VMCI. However, the complex nature of cognitive processing in VMCI suggests that a multifaceted approach, that integrates both visual and verbal assessments, may ultimately offer the most comprehensive evaluation. Clinical Trial: Not Applicable