A Screen for Cognitive Assessments for Patients with Vascular Cognitive Impairment No Dementia

Objective: To screen for cognitive assessment for patients with vascular cognitive impairment (VCI) no dementia (V-CIND) from a set of cognitive measures.

Methods: Extensive neuropsychological tests covering five cognitive domains were performed on 80 V-CIND patients and 80 normal controls. The impaired domains in V-CIND were determined and the most discriminating tests were selected to form a comprehensive assessment. The discriminating validity of the individual tests and the comprehensive assessment were explored.

Results: Compared with the control group, five cognitive domains were all impaired in V-CIND group. World Health Organization-University of California-Los Angeles Auditory Verbal Learning Test (WHO-UCLA AVLT) immediate recall, Semantic Category Verbal Fluency Test (animal), Chinese version of the Wechsler Adult Intelligence Test (WAIS-RC) Digit Symbol Subtest, and Block Design Subtest were finally selected to form a comprehensive assessment tool, which achieved a sensitivity of 92.5% and a specificity of 98.8% in differentiating V-CIND patients from normal controls. Even in the subjects with Mini-Mental State Examination (MMSE) scores of 28 or above, high discriminative validity was also obtained.

Conclusions: Our study revealed a multiple domain cognitive deficit in V-CIND patients. The comprehensive assessment tapping memory, executive functions, mental processing speed, and visuoconstructive skill may be potentially useful for an overall cognitive evaluation for V-CIND.