Detection of Vascular Mild Cognitive Impairment in Southeast Asia Using the Visual Cognitive Assessment Test: Machine Learning Analysis From the BIOCIS (Biomarkers and Cognition Study, Singapore)

Abstract

Background: Vascular mild cognitive impairment (VMCI) is a significant global health concern, particularly in Asia. The visual cognitive assessment test (VCAT) has shown promise as a language-neutral screening tool for cognitive impairment. Objective: This study aims to assess the effectiveness of the VCAT in detecting VMCI and compare its diagnostic performance with the widely used and validated Montreal Cognitive Assessment (MoCA). Methods: Cross-sectional data from 524 community-dwelling participants were analyzed from the BIOCIS (Biomarkers and Cognition Study, Singapore) and classified into cognitively unimpaired, non-VMCI, and VMCI groups. The participants underwent neuropsychological assessments and 3-T magnetic resonance imaging. The random forest technique and multivariable logistic regression were applied to assess the discriminative properties of the tests. Results: Participants with VMCI exhibited significantly lower performance across various neuropsychological tests (P