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Meta-Analysis
. 2023 Oct 31:11:1293710.
doi: 10.3389/fpubh.2023.1293710. eCollection 2023.

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

Jui-Hung Hsu #  1 , Chien-Cheng Liu  2   3   4 , I-Wen Chen #  1 , Jheng-Yan Wu  5 , Po-Yu Huang  6 , Ting-Hui Liu  7 , Kuo-Chuan Hung  8   9
Affiliations
Meta-Analysis

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

Jui-Hung Hsu et al. Front Public Health. .

Abstract

Background: Mild 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.

Methods: Medline, 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.

Results: Five 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).

Conclusion: VCAT 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 registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42023453453.

Keywords: mild cognitive impairment; mild dementia; sensitivity; specificity; visual cognitive assessment test.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart for study selection.
Figure 2
Figure 2
Methodological quality summary.
Figure 3
Figure 3
Forest plot showing low visual cognitive assessment test (VCAT) values in patients with mild cognitive impairment (MCI)/mild dementia compared with those without MCI/mild dementia.
Figure 4
Figure 4
Forest plot depicting the combined sensitivity and specificity of 80% (68%–88%) and 75% (68%–80%), respectively, of the VCAT for mild cognitive impairment (MCI)/mild dementia.
Figure 5
Figure 5
Hierarchical summary receiver operating characteristic (HSROC) curves illustrating an area under the curve (AUC) of 0.77.
Figure 6
Figure 6
Fagan’s nomogram revealing the post-test probability of mild cognitive impairment (MCI)/mild dementia.
Figure 7
Figure 7
Deek’s funnel plot showing a low risk of publication bias (p = 0.65).
See this image and copyright information in PMC

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