Frontiers in Public Health (Oct 2023)

Efficacy of the visual cognitive assessment test for mild cognitive impairment/mild dementia diagnosis: a meta-analysis

  • Jui-Hung Hsu,
  • Chien-Cheng Liu,
  • Chien-Cheng Liu,
  • Chien-Cheng Liu,
  • I-Wen Chen,
  • Jheng-Yan Wu,
  • Po-Yu Huang,
  • Ting-Hui Liu,
  • Kuo-Chuan Hung,
  • Kuo-Chuan Hung

DOI
https://doi.org/10.3389/fpubh.2023.1293710
Journal volume & issue
Vol. 11

Abstract

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BackgroundMild cognitive impairment (MCI) is an intermediate stage between normal ageing and dementia. The early identification of MCI is important for timely intervention. The visual cognitive assessment test (VCAT) is a brief language-neutral screening tool for detecting MCI/mild dementia. This meta-analysis evaluated the diagnostic efficacy of the VCAT for MCI/mild dementia.MethodsMedline, Embase, Google Scholar, and Cochrane Library were searched from their inception until August 2023 to identify studies using VCAT to diagnose MCI/mild dementia. The primary outcome was to assess the diagnostic accuracy of the VCAT for detecting MCI/mild dementia through area under the receiver operating characteristic curve (AU-ROC) analysis. The secondary outcome was to explore the correlation between VCAT scores and MCI/mild dementia presence by comparing scores among patients with and without MCI/mild dementia. Pooled sensitivity, specificity, and area under the curve (AUC) were calculated.ResultsFive studies with 1,446 older adults (mean age 64–68.3 years) were included. The percentage of participants with MCI/mild dementia versus controls ranged from 16.5% to 87% across studies. All studies were conducted in Asian populations, mostly Chinese, in Singapore and Malaysia. The pooled sensitivity was 80% [95% confidence interval (CI) 68%–88%] and the specificity was 75% (95% CI 68%–80%). The AU-ROCC was 0.77 (95% CI 0.73–0.81). Patients with MCI/mild dementia had lower VCAT scores than the controls (mean difference −6.85 points, p < 0.00001).ConclusionVCAT demonstrated acceptable diagnostic accuracy in distinguishing MCI/mild dementia in cognitively normal older adults. As a language-neutral and culturally unbiased tool, the VCAT shows promise in detecting MCI/mild dementia. Further studies in non-Asian populations are required.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42023453453.

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