Cited by 852Dementia and Cognitive Impairment ResearchNeurological Disease Mechanisms and TreatmentsHistorical and Modern Theater Studies

The DOI matches its Crossref record; 81 of the 88 references it cites were found in a registry or an index; none of the 69 sources its claims cite is checked for support yet.

Diagnostic Criteria for Vascular Cognitive Disorders: A VASCOG Statement

Open access

Abstract

BACKGROUND: Several sets of diagnostic criteria have been published for vascular dementia since the 1960s. The continuing ambiguity in vascular dementia definition warrants a critical reexamination. METHODS: Participants at a special symposium of the International Society for Vascular Behavioral and Cognitive Disorders (VASCOG) in 2009 critiqued the current criteria. They drafted a proposal for a new set of criteria, later reviewed through multiple drafts by the group, including additional experts and the members of the Neurocognitive Disorders Work Group of the fifth revision of Diagnostic and Statistical Manual (DSM-5) Task Force. RESULTS: Cognitive disorders of vascular etiology are a heterogeneous group of disorders with diverse pathologies and clinical manifestations, discussed broadly under the rubric of vascular cognitive disorders (VCD). The continuum of vascular cognitive impairment is recognized by the categories of Mild Vascular Cognitive Disorder, and Vascular Dementia or Major Vascular Cognitive Disorder. Diagnostic thresholds are defined. Clinical and neuroimaging criteria are proposed for establishing vascular etiology. Subtypes of VCD are described, and the frequent cooccurrence of Alzheimer disease pathology emphasized. CONCLUSIONS: The proposed criteria for VCD provide a coherent approach to the diagnosis of this diverse group of disorders, with a view to stimulating clinical and pathologic validation studies. These criteria can be harmonized with the DSM-5 criteria such that an international consensus on the criteria for VCD may be achieved.

Overview

Integrity signals

Registry

Crossref · 10.1097/wad.0000000000000034

Cites

81 of 81 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

48 Not checked yet · 3 Own interpretation · 2 Own method

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  • It may state two separate claims as one. 18
  • Probably not a substantial claim. 6
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  • The paper relies on this without support.

    The term dementia has increasingly become equated with AD in the popular mind.

    “The term dementia has increasingly become equated with AD in the popular mind, even though AD accounts just over one-half of all cases of dementia.11”
  • The paper relies on this without support.

    Potentially disease-modifying treatments may be more effective before the late stage identified by the VaD threshold.

    “Yet potentially disease-modifying treatments may be more effective before this stage is reached.”
  • The paper relies on this without support.

    The temporal relationship between cerebrovascular events and cognitive impairment is not difficult to establish clinically.

    “This pattern is temporally related to cerebrovascular events of infarction, hemorrhage or vasculitis, and the temporal relationship is not difficult to establish clinically.”
  • The paper relies on this without support.

    VCD with gradual onset and slow progression is generally due to small vessel disease leading to lesions in the white matter, basal ganglia, and/or thalamus.

    “VCD with a gradual onset and slow progression is generally due to small vessel disease leading to lesions in the white matter, basal ganglia and/or thalamus.”
  • The paper relies on this without support.

    Neuropsychiatric features are not specific to vascular etiology.

    “As these neuropsychiatric features are not specific to vascular etiology, they are not considered to be core diagnostic features, yet may be the presenting symptoms.”
  • The paper relies on this without support.

    No neuroimaging feature is pathognomonic of VCD.

    “The findings are varied and there is no feature that is pathognomonic of VCD.”
  • The paper relies on this without support.

    VCD can occur without evidence of brain infarcts.

    “It is generally accepted that VCD can occur without evidence of brain infarcts, although the latter are usually present.”
  • The paper relies on this without support.

    Focal WMLs visible only on T2-weighted MRI are unlikely to be significant enough to explain the development of a cognitive disorder.

    “If the WMLs are focal and visible only on T2-weighted MRI, they are unlikely to be significant enough to explain the development of a cognitive disorder.”
  • The paper relies on this without support.

    Subdural hemorrhage is usually caused by trauma and not by vascular pathology.

    “Since SH is usually a result of trauma and not vascular pathology, it should be not be regarded as a VCD.”
  • The paper relies on this without support.

    Subarachnoid hemorrhage is due to vascular pathology.

    “SAH is due to vascular pathology and its associated cognitive deficits are appropriately regarded as VCD.”
  • The paper relies on this without support.

    Incidental brain infarctions and white matter lesions are common in the brains of older individuals.

    “Since incidental brain infarctions and WMLs are common in brains of older individuals, it is important to consider other possible etiologies when a cognitive disorder is present.”
  • The paper relies on this without support.

    Microbleeds are not uncommon in cognitively normal older individuals.

    “Since microbleeds are not uncommon in cognitively normal older individuals, attribution of the VCD to these, especially VaD, should follow a careful exclusion of other causes of cognitive impairment and only if numerous such lesions are present.”
  • The paper relies on this without support.

    Vascular cognitive disorder is often associated with psychiatric or behavioral symptoms.

    “VCD is often associated with psychiatric or behavioral symptoms that may pose special challenges for their treatment.”
  • The paper relies on this without support.

    No single profile of depression or psychosis is specific to vascular cognitive disorder.

    “While some attempts have been made to develop specific criteria for syndromes such as depression and psychosis associated with cognitive disorders,84 there is no one profile that is specific to VCD.”
  • The paper relies on this without support.

    The heterogeneity of vascular cognitive disorder has made development of reliable non-imaging biomarkers extremely challenging.

    “The heterogeneity of VCD has made the development of reliable non-imaging biomarkers extremely challenging.”
  • The paper relies on this without support.

    None of the suggested cerebrospinal fluid biomarkers is specific to vascular cognitive disorder.

    “As none of these is specific to VCD, they are not currently recommended for use for this diagnostic purpose.”
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Research works printed but not linked: 1

  1. Skoog, 2000, Vascular aspects in Alzheimers disease., J Neural Transm Suppl, 59, 37

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Metadata

Authors
Sachdev, P., Kalaria, R., O’Brien, J., Skoog, I., Alladi, S., Black, S. E., Blacker, D., Blazer, D. G., Chen, C., Chui, H., Ganguli, M., Jellinger, K., Jeste, D. V., Pasquier, F., Paulsen, J., Prins, N., Rockwood, K., Roman, G., & Scheltens, P.
Affiliations
  • University of Southern California (US)
  • Newcastle University (GB)
  • University of Gothenburg (SE)
  • Nizam's Institute of Medical Sciences (IN)
  • Sunnybrook Health Science Centre (CA)
  • UNSW Sydney (AU)
  • Prince of Wales Hospital (AU)
  • University of Cambridge (GB)
Corresponding author
  • Sachdev, Perminder
  • Blacker, Deborah
  • Pasquier, Florence
Venue
Alzheimer Disease & Associated Disorders
Published
2014-07
Volume
28
Issue
3
Pages
206-218
ISSN
0893-0341 (ISSN-L)
OpenAlex
W2035892177
Cited by
852
References
88
Citations by year
2026: 94 · 2025: 106 · 2024: 97 · 2023: 75 · 2022: 72 · 2021: 98 · 2020: 75 · 2019: 81 · 2018: 43 · 2017: 46 · 2016: 35 · 2015: 22 · 2014: 7
FWCI
27.97
Type
journal article
Language
en
Open access
Locations
  • Alzheimer Disease & Associated Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • PubMed Central (acceptedVersion)
  • UNSWorks (UNSW Sydney) (submittedVersion, cc-by-nc-nd)
  • eScholarship (California Digital Library) (submittedVersion)
  • UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Newcastle University ePrints (Newcastle Univesity)
Funders
  • Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
  • Medical Research Council (MR/L016451/1)
  • Australian Research Council (DP120102078)
  • NIHR Newcastle Biomedical Research Centre (BH111030)
  • National Institute on Aging (P50AG005142, P50AG005134, K07AG044395, P30AG062421)
  • National Institute of Mental Health (R01MH071536)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
  • Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
Keywords
vascular dementia, diagnostic criteria, vascular etiology, Alzheimer disease pathology, DSM-5
MeSH terms
Cognition Disorders, Humans, Dementia, Vascular

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