Sachdev Perminder S, Bentvelzen Adam C, Kochan Nicole A, Jiang Jiyang, Hosoki Satoshi, Koncz Rebecca, Chander Russell J, Saks Danit, Aben Hugo P, Acosta Daisy, Andersen Pia, Assal Frédéric, Bae Hee-Joon, Biessels Geert Jan, Blacker Deborah, Bordet Régis, Briceno Emily M, Brodaty Henry, Brodtmann Amy, Caramelli Paulo, Castro-Costa Erico, Chabriat Hugues, Chen Christopher, Clancy Una, Cysique Lucette, DeCarli Charles, Ding Ding, Duering Marco, Engelhardt Eliasz, Gauthier Serge, Geranmayeh Fatemeh, Godefroy Olivier, Gorelick Philip, Greenberg Steven M, Jelic Vesna, Jokinen Hanna, Kalaria Raj N, Krishna Murali, Lancaster Kurt, de Leeuw Frank-Erik, Lim Jae-Sung, Marseglia Anna, Marta-Moreno Javier, O'Brien John T, Pantoni Leonardo, Pase Matthew P, Pendlebury Sarah T, Rosenberg Gary, Sabayan Behnam, Salvadori Emilia, Samaras Katherine, Sebastian Ivy Anne, Seshadri Sudha, Smith Eric E, Srikanth Velandai, Stokes Kathryn, Sudo Felipe Kenji, Sveikata Lukas, Valenzuela Michael, Wallin Anders, Wardlaw Joanna M, Xu Qun
Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia.
Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia.
JAMA Neurol. 2025 Sep 16. doi: 10.1001/jamaneurol.2025.3242.
Several sets of diagnostic criteria have been proposed for vascular cognitive impairment and dementia (VCID). The International Society for Vascular Behavioural and Cognitive Disorders (VasCog) working group published comprehensive operationalized criteria in 2014. Considering subsequent advances in the field, a revision was needed.
To update the VasCog criteria to achieve consensus on diagnosis of VCID.
DESIGN, SETTING, AND PARTICIPANTS: VasCog criteria and other published diagnostic guidelines, aided by literature review of recent developments in VCID, were used as reference points for an online Delphi survey (minimum 3 rounds, ≥75% threshold for agreement), including operationalization of criteria and guidance on potential biomarkers. Seventy international experts from diverse international regions were invited to participate in 2023.
Three survey rounds included 49 to 54 participants that agreed on VasCog-2 diagnostic criteria for preclinical, mild, and major dementia levels of vascular cognitive impairment (under the overarching term VCID). Research guidelines, including the use of novel neuroimaging and fluid biomarkers, were also agreed on. The World Stroke Organization (WSO) endorsed the criteria, hence named VasCog-2-WSO.
The VasCog-2-WSO criteria update the VasCog criteria for the diagnosis of VCID, providing operationalization and additional guidance on potential neuroimaging and fluid biomarkers. VasCog-2-WSO should provide an international standard for VCID diagnosis, facilitating diagnostic consistency among clinicians and researchers.
已针对血管性认知障碍和痴呆（VCID）提出了几套诊断标准。国际血管行为和认知障碍协会（VasCog）工作组于2014年发布了全面的可操作标准。鉴于该领域随后的进展，需要进行修订。
更新VasCog标准，以就VCID的诊断达成共识。
设计、背景和参与者：VasCog标准及其他已发表的诊断指南，辅以对VCID近期进展的文献综述，被用作在线德尔菲调查（至少三轮，达成一致的阈值≥75%）的参考点，包括标准的可操作化以及关于潜在生物标志物的指导。邀请了来自不同国际地区的70位国际专家于2023年参与。
三轮调查共有49至54名参与者就血管性认知障碍的临床前、轻度和重度痴呆水平的VasCog-2诊断标准（在总体术语VCID之下）达成一致。还就研究指南达成了一致，包括新型神经影像学和体液生物标志物的使用。世界卒中组织（WSO）认可了这些标准，因此命名为VasCog-2-WSO。
VasCog-2-WSO标准更新了用于诊断VCID的VasCog标准，提供了可操作化以及关于潜在神经影像学和体液生物标志物的额外指导。VasCog-2-WSO应为VCID诊断提供国际标准，促进临床医生和研究人员之间的诊断一致性。
