Clinical Manifestations.

Abstract

A delay in the detection of Mild Cognitive Impairment (MCI) in the community delays the opportunity for early intervention. Accurate tools to detect MCI in the community are lacking. The Visual Cognitive Assessment Test (VCAT) is a visual based cognitive test useful for multilingual populations without the need for translation. Here, we evaluate the usefulness of VCAT in detecting MCI in a community population in Singapore. We recruited 469 participants from the community who completed a detailed neuropsychological assessment and 261 of them completed a 3T Magnetic Resonance Imaging (MRI) brain scan. We performed a ROC analysis to test the diagnostic performance of VCAT compared to MoCA in distinguishing mild cognitive impairment (MCI) from cognitively normal (CN) by measuring area under the curve (AUC). To test for the association of VCAT with structural MRI, we performed a Pearson's correlation analysis for VCAT and MRI variables. We recruited 39 CN, 168 subjective cognitive decline and 262 MCI participants from Dementia Research Centre (Singapore). Mean age of the cohort was 62.77, SD = 9.57, mean education years was 13.97, SD = 3.41 and majority were women (57.8%). VCAT was effective in detecting MCI from CN with an AUC of 0.794 (95% CI 0.723-0.865) which was slightly higher than MOCA 0.699 (95% CI 0.621-0.777). Among subjects with MCI, VCAT was associated with medial temporal lobe atrophy (MTA) (ρ = -0.265, p = 0.001). The VCAT is useful in detecting MCI in the community in Singapore and may be an effective measure of neurodegeneration.