Review of the Efficacy of Methods in the Early Detection of Vascular Dementia
Objective: The objective of this review was to compare methods of assessing for the early detection of vascular neurocognitive disorder (VaD) to understand what assessments aid clinicians in forming the most accurate diagnosis.
Data Selection: Peer-reviewed studies conducted between 1998 and 2020 were abstracted from the EBSCO and the ScienceDirect database. Search criteria was confined to vascular dementia, early detection/cognitive decline, and neuropsychological assessment efficacy. Data on late-stage/non-vascular dementia, medical conditions, and mental disorders were excluded. A final selection of fourteen articles were reviewed based on criteria that excluded information on outdated assessments, assessments integrated with other tests, and any references to data obtained prior to DSM-III-R. An additional six articles on commonly used medical assessments were reviewed.
Data Synthesis: Synthesis of findings revealed the Cambridge Cognitive Examination (CAMCOG) and Montreal Cognitive Assessment (MoCA) surpassed the efficacy of the Mini Mental Status examination (MMSE) in early diagnosis. The MMSE and Mattis Dementia Rating Scale (DRS) exhibited good diagnostic differentiation power. The Clinical Dementia Rating (CDR) effectively detected early features of a transitional stage prior to the onset of full-blown dementia. There were findings for the usefulness of the Addenbrooke’s Cognitive Examination-III (ACE-III) and Wechsler Memory Scale-3rd Edition (WMS-III). The Clock Drawing Test (CDT), Olfactory Function Test (OFT), and Pocket Smell Test (PST) can supplement other assessments for early VaD.
Conclusions: Support was found for administering more than one assessment to increase confidence in diagnosis. Each test had its own strengths and weaknesses such that using only one test results in less accurate diagnosis.