Article Impact Level: HIGH Data Quality: STRONG Summary of JAMA Neurology. https://doi.org/10.1001/jamaneurol.2025.3242 Dr. Perminder S. Sachdev et al.
Points
- New VasCog-2-WSO criteria provide updated diagnostic guidance for vascular cognitive impairment and dementia.
- International experts achieved consensus on criteria for preclinical, mild, and major dementia levels of VCID.
- Biomarkers are incorporated into the criteria primarily to suggest alternative or co-occurring etiologies.
- The World Stroke Organization endorsed these criteria, establishing an international standard for VCID diagnosis.
- The VasCog-2-WSO criteria aim to enhance diagnostic consistency among clinicians and researchers.
Summary
This Delphi study aimed to achieve international consensus on updated diagnostic criteria for vascular cognitive impairment and dementia (VCID), building upon the 2014 VasCog criteria. Seventy international experts were invited to participate in 2023, with 49 to 54 individuals engaging across three survey rounds. The objective was to refine the criteria, incorporate recent research, and provide operationalized guidance, including the judicious use of neuroimaging and fluid biomarkers to differentiate VCID from alternative or concomitant etiologies.
The expert panel reached consensus on the VasCog-2 diagnostic criteria for preclinical, mild, and major dementia levels of VCID. Agreement was also established for research guidelines, specifically addressing the integration of novel neuroimaging and fluid biomarkers. Notably, the World Stroke Organization (WSO) endorsed these revised criteria, leading to their designation as the VasCog-2-WSO criteria. This endorsement signifies a move towards a unified international standard for VCID diagnosis.
The VasCog-2-WSO criteria address a critical need for standardized, operationalizable diagnostic tools in VCID, which accounts for 15% to 20% of dementia cases and where cerebrovascular disease contributes to cognitive decline in up to 75% of all persons with dementia. By providing clear guidance and integrating advancements in neuroimaging and biomarkers, these criteria aim to improve diagnostic consistency among clinicians and researchers, thereby advancing both clinical practice and research in this complex field.
Link to the article: https://jamanetwork.com/journals/jamaneurology/fullarticle/2839119
References
The VasCog-2-WSO Criteria Consortium, Sachdev, P. S., Bentvelzen, A. C., Kochan, N. A., Jiang, J., Hosoki, S., Koncz, R., Chander, R. J., Saks, D., Aben, H. P., Acosta, D., Andersen, P., Assal, F., Bae, H.-J., Biessels, G. J., Blacker, D., Bordet, R., Briceno, E. M., Brodaty, H., … Xu, Q. (2025). Revised diagnostic criteria for vascular cognitive impairment and dementia—The vascog-2-wso criteria. JAMA Neurology. https://doi.org/10.1001/jamaneurol.2025.3242
