Consensus-Harmonized Neuropsychological Assessment for Vascular Cognitive Impairment and Dementia

Abstract

Importance Harmonization of neuropsychological assessment for vascular cognitive impairment and dementia (VCID) is important for ensuring the highest standards and consistency of diagnosis. A battery proposed in 2006 by the National Institute for Neurological Disorders and Stroke and the Canadian Stroke Network (NINDS-CSN) has received much international support. Considering significant advances in the field, including the rise of computerized and remote assessment methods, a revision is needed. Objective To develop an updated harmonized battery and associated assessment guidelines for VCID. Evidence Review NINDS-CSN and other relevant published harmonized neuropsychological batteries, aided by literature review of recent developments in VCID, were used as reference points for an online Delphi survey (≥3 rounds, ≥75% threshold for agreement), including questions on a core test battery based on key cognitive domains that should be assessed for VCID, consideration of computerized and remote assessment methods, and assessment of diverse populations. International experts in neuropsychological assessment from diverse international regions were invited to participate in 2023. Data were analyzed from October 11, 2023, to June 20, 2024. Findings A total of 44 experts participated in 3 survey rounds, with 28 to 31 participants each. Consensus was reached on a core assessment battery of neuropsychological tests based on key cognitive domains, and additional guidelines for a more comprehensive test battery, cognitive screening, telehealth and computerized assessment methods, principles for normative standardization, and the assessment of diverse populations. The key cognitive domains were harmonized with the International Society for Vascular Behavioural and Cognitive Disorders version 2 World Stroke Organization (VasCog-2-WSO) diagnostic criteria for VCID. Conclusions and Relevance This consensus statement describes the development of a harmonized neuropsychological assessment battery and guidelines for VCID (VasCog-NP) that expands on the NINDS-CSN battery with more comprehensive and flexible assessment of VCID. Harmonized with the VasCog-2-WSO diagnostic criteria, VasCog-NP could be adopted internationally to further help more consistent neuropsychological evaluations related to VCID, facilitating global comparisons for clinicians and researchers.

Affiliated Institutions

• Hallym University KR
• University of Milan IT
• Helsinki University Hospital FI
• The George Institute for Global Health AU
• University of Massachusetts Chan Medical School US
• St Vincent's Hospital Sydney AU
• Université de Picardie Jules Verne FR
• Monash University AU
• Istituto Universitario di Studi Superiori di Pavia IT
• UK Dementia Research Institute GB
• University of Toronto CA
• University of Newcastle Australia AU
• Stockholm University SE
• Prince of Wales Hospital AU
• UNSW Sydney AU
• Karolinska Institutet SE
• Baycrest Hospital CA
• University of Edinburgh GB
• D’Or Institute for Research and Education BR
• University of the Sunshine Coast AU
• St Vincent's Hospital Melbourne AU
• University of Trento IT
• Geriatric Research Education and Clinical Center US
• Universidade Federal do Maranhão BR
• University of California, San Diego US
• University of Michigan US
• Imperial College London GB
• St Olav's University Hospital
• University of Helsinki FI
• Alzheimer’s Disease Neuroimaging Initiative US
• Kymenlaakson keskussairaala FI
• Istituti Clinici Scientifici Maugeri IT
• Vincent Van Gogh Voor Geestelijke Gezondheidszorg NL
• Radboud University Nijmegen NL

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