Pricilia Tanoto, Hannah En Ye, Seyed Ehsan Saffari, Yi Jin Leow, Ashwati Vipin, Faith Phemie Hui En Lee, Smriti Ghildiyal, Shan Yao Liew, Adnan Azam Mohammed, Gurveen Kaur Sandhu, Kiirtaara Aravindhan, Gursimar Bhalla, Rasyiqah Binte Shaik Mohamed Salim, Nagaendran Kandiah
{"title":"使用视觉认知评估测试检测东南亚血管性轻度认知障碍：来自BIOCIS（生物标志物和认知研究，新加坡）的机器学习分析。","authors":"Pricilia Tanoto, Hannah En Ye, Seyed Ehsan Saffari, Yi Jin Leow, Ashwati Vipin, Faith Phemie Hui En Lee, Smriti Ghildiyal, Shan Yao Liew, Adnan Azam Mohammed, Gurveen Kaur Sandhu, Kiirtaara Aravindhan, Gursimar Bhalla, Rasyiqah Binte Shaik Mohamed Salim, Nagaendran Kandiah","doi":"10.2196/76847","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>This study aims to assess the effectiveness of the VCAT in detecting VMCI and compare its diagnostic performance with the widely used and validated Montreal Cognitive Assessment (MoCA).</p><p><strong>Methods: </strong>Cross-sectional data from 524 community-dwelling participants were analyzed from the BIOCIS (Biomarkers and Cognition Study, Singapore) and classified into cognitively unimpaired, non-VMCI, and VMCI groups. The participants underwent neuropsychological assessments and 3-T magnetic resonance imaging. The random forest technique and multivariable logistic regression were applied to assess the discriminative properties of the tests.</p><p><strong>Results: </strong>Participants with VMCI exhibited significantly lower performance across various neuropsychological tests (P<.001) and higher rates of vascular risk factors (P<.001). At a cutoff of 27, the VCAT achieved near-perfect accuracy in discriminating the VMCI group from the cognitively unimpaired group (area under the receiver operating characteristic curve=1; sensitivity=1; specificity=0.991). For differentiating the VMCI group from the non-VMCI group, both the VCAT and the MoCA showed optimal performance at a cutoff of 25 (area under the receiver operating characteristic curve=1.00; sensitivity=1.00; specificity=1.00).</p><p><strong>Conclusions: </strong>The VCAT could be a valuable tool for detecting VMCI, particularly in diverse, multilingual populations. Its comparable or even superior performance to the MoCA, combined with its language-neutral design, positions the 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.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.14283/jpad.2024.89.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"8 ","pages":"e76847"},"PeriodicalIF":4.8000,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Detection of Vascular Mild Cognitive Impairment in Southeast Asia Using the Visual Cognitive Assessment Test: Machine Learning Analysis From the BIOCIS (Biomarkers and Cognition Study, Singapore).\",\"authors\":\"Pricilia Tanoto, Hannah En Ye, Seyed Ehsan Saffari, Yi Jin Leow, Ashwati Vipin, Faith Phemie Hui En Lee, Smriti Ghildiyal, Shan Yao Liew, Adnan Azam Mohammed, Gurveen Kaur Sandhu, Kiirtaara Aravindhan, Gursimar Bhalla, Rasyiqah Binte Shaik Mohamed Salim, Nagaendran Kandiah\",\"doi\":\"10.2196/76847\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>This study aims to assess the effectiveness of the VCAT in detecting VMCI and compare its diagnostic performance with the widely used and validated Montreal Cognitive Assessment (MoCA).</p><p><strong>Methods: </strong>Cross-sectional data from 524 community-dwelling participants were analyzed from the BIOCIS (Biomarkers and Cognition Study, Singapore) and classified into cognitively unimpaired, non-VMCI, and VMCI groups. The participants underwent neuropsychological assessments and 3-T magnetic resonance imaging. The random forest technique and multivariable logistic regression were applied to assess the discriminative properties of the tests.</p><p><strong>Results: </strong>Participants with VMCI exhibited significantly lower performance across various neuropsychological tests (P<.001) and higher rates of vascular risk factors (P<.001). At a cutoff of 27, the VCAT achieved near-perfect accuracy in discriminating the VMCI group from the cognitively unimpaired group (area under the receiver operating characteristic curve=1; sensitivity=1; specificity=0.991). For differentiating the VMCI group from the non-VMCI group, both the VCAT and the MoCA showed optimal performance at a cutoff of 25 (area under the receiver operating characteristic curve=1.00; sensitivity=1.00; specificity=1.00).</p><p><strong>Conclusions: </strong>The VCAT could be a valuable tool for detecting VMCI, particularly in diverse, multilingual populations. Its comparable or even superior performance to the MoCA, combined with its language-neutral design, positions the 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.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.14283/jpad.2024.89.</p>\",\"PeriodicalId\":36245,\"journal\":{\"name\":\"JMIR Aging\",\"volume\":\"8 \",\"pages\":\"e76847\"},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2025-10-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JMIR Aging\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2196/76847\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JMIR Aging","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2196/76847","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
Detection of Vascular Mild Cognitive Impairment in Southeast Asia Using the Visual Cognitive Assessment Test: Machine Learning Analysis From the BIOCIS (Biomarkers and Cognition Study, Singapore).
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 aims to assess the effectiveness of the VCAT in detecting VMCI and compare its diagnostic performance with the widely used and validated Montreal Cognitive Assessment (MoCA).
Methods: Cross-sectional data from 524 community-dwelling participants were analyzed from the BIOCIS (Biomarkers and Cognition Study, Singapore) and classified into cognitively unimpaired, non-VMCI, and VMCI groups. The participants underwent neuropsychological assessments and 3-T magnetic resonance imaging. The random forest technique and multivariable logistic regression were applied to assess the discriminative properties of the tests.
Results: Participants with VMCI exhibited significantly lower performance across various neuropsychological tests (P<.001) and higher rates of vascular risk factors (P<.001). At a cutoff of 27, the VCAT achieved near-perfect accuracy in discriminating the VMCI group from the cognitively unimpaired group (area under the receiver operating characteristic curve=1; sensitivity=1; specificity=0.991). For differentiating the VMCI group from the non-VMCI group, both the VCAT and the MoCA showed optimal performance at a cutoff of 25 (area under the receiver operating characteristic curve=1.00; sensitivity=1.00; specificity=1.00).
Conclusions: The VCAT could be a valuable tool for detecting VMCI, particularly in diverse, multilingual populations. Its comparable or even superior performance to the MoCA, combined with its language-neutral design, positions the 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.
International registered report identifier (irrid): RR2-10.14283/jpad.2024.89.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
