| AHA/ASA | VAS-COG Society | DSM-5 |
| Cognitive criteria |
- Discriminates between vascular mild cognitive impairment and vascular dementia.
| - Discriminates between mild and major vascular cognitive disorder (dementia).
| - Discriminates between mild and major vascular neurocognitive disorder.
|
| Criteria for probable vascular cognitive impairment |
- There is imaging evidence of cerebrovascular disease and either:
- There is a clear temporal relationship between a vascular event (eg, clinical stroke) and onset of cognitive deficits.
- OR
- There is a clear relationship in the severity and pattern of cognitive impairment and the presence of diffuse, subcortical cerebrovascular disease pathology.
- There should be no history of gradually progressive cognitive deficits before or after stroke that suggest the presence of a nonvascular cognitive disorder (eg, Alzheimer disease).
| - Either:
- The onset of cognitive deficits follows one or more strokes or there are physical signs consistent with stroke.
- OR
- If history of stroke or transient ischemic attack is absent, then there is evidence of cognitive decline in speed of information processing, complex attention, or frontal executive functions, accompanied by one or more of: gait disturbances, urinary symptoms, or personality and mood changes.
- There should be neuroimaging evidence of either large vessel infarct, strategically placed single infarct(s) or intracerebral hemorrhage(s), multiple (more than two) lacunar infarcts outside the brainstem, or extensive and confluent white matter lesions.
- There should not be evidence of other nonvascular cognitive, medical, psychiatric, or neurologic disorders sufficient to explain the cognitive impairment (including Alzheimer disease).
| - The criteria are met for mild or major neurocognitive disorder.
- The clinical features are consistent with a vascular etiology, as suggested by either of the following:
- Onset of the cognitive deficits is temporally related to one or more cerebrovascular events.
- OR
- Evidence for decline is prominent in complex attention (including processing speed) and frontal executive function.
- There is evidence of the presence of cerebrovascular disease from history, physical examination, and/or neuroimaging considered sufficient to account for the neurocognitive deficits.
- The symptoms are not better explained by another brain disease or systemic disorder.
- Probable vascular neurocognitive disorder is diagnosed if one of the following is present; otherwise possible vascular neurocognitive disorder should be diagnosed:
- Clinical criteria are supported by neuroimaging evidence of significant parenchymal injury attributed to cerebrovascular disease (neuroimaging supported).
- OR
- The neurocognitive syndrome is temporally related to one or more documented cerebrovascular events.
- OR
- Both clinical and genetic (eg, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy) evidence of cerebrovascular disease is present.
|
| Criteria for possible vascular cognitive impairment |
- Meets criteria except that there is no clear relationship between the vascular disease and the cognitive impairment, there is insufficient information (eg, neuroimaging studies are not available), severe aphasia precludes accurate cognitive assessment, or there is evidence of other neurodegenerative conditions (eg, Alzheimer disease) in addition to cerebrovascular disease.
| - Meets criteria except that neuroimaging is not available.
| - Clinical criteria are met but neuroimaging is not available and the temporal relationship of the neurocognitive syndrome with one or more cerebrovascular events is not established.
|
| Classification when other potential causes are present (ie, mixed disease) |
- Possible vascular mild cognitive impairment or dementia should be diagnosed when there is evidence of other neurodegenerative conditions.
| - Vascular mild/major cognitive disorder with concomitant Alzheimer disease may be diagnosed when the patient additionally meets criteria for probable or possible Alzheimer disease.
| - Not specifically addressed.
|
