Table 1 VASCOG2-WSO Criteria for mild vascular cognitive impairment and vascular dementia, developed through an international Delphi process, adapted from Sachdev et al. (2025).
Part A. Criteria for mild cognitive impairment and dementia | |
|---|---|
Mild cognitive impairment (both A and B are necessary) | |
(A) Acquired decline from a documented or inferred previous level of performance in one or more cognitive domains as evidenced by the following: | |
| Â | (a) Concerns of the person, knowledgeable informant or a clinician of mild levels of decline |
|  | (b) Evidence of modest deficits on objective cognitive assessment in ≥ 1 cognitive domain |
(B) The cognitive deficits are not sufficient to interfere with independence | |
Dementia (both A and B are necessary) | |
(A) Evidence of substantial cognitive decline from a documented or inferred previous level of performance in one or more cognitive domains, based on: | |
| Â | (a) Concerns of the person, a knowledgeable informant, or the clinician, of significant decline; |
|  | (b) Clear and significant deficits in objective assessment based on a validated objective measure of neurocognitive function in ≥ 1 cognitive domain. |
(B) The cognitive deficits are sufficient to interfere with independence | |
Part B. Evidence for predominantly vascular etiology of cognitive impairment. | |
(A) One of the following clinical features (A.1. or A.2.) | |
1 | The onset of the cognitive deficits is temporally related to ≥ 1 clinical strokes. The evidence of stroke is one of the following |
| Â | (a) Documented history of a stroke, with cognitive decline temporally associated with the event |
| Â | (b) Physical signs consistent with stroke |
2 | If no history or signs of stroke, cognitive decline has more gradual onset and course, typically predominant in some combination of attention and processing speed, and/or executive functioning. |
(B) Presence of significant neuroimaging MRI (preferable) or CT evidence of cerebrovascular disease (at least one of the following) | |
1 | Multiple infarcts or a single extensive or strategically placed infarct |
2 | Multiple lacunes outside the brainstem, one lacune may be sufficient if strategically placed or in combination with extensive white matter hyperintensities. |
3 | White matter hyperintensities, particularly if they are extensive and confluent. |
4 | Multiple intracerebral hemorrhages; one may be sufficient if large and/or in a lobar location or otherwise strategically placed |
(C) Features that May Suggest an Alternative or Additional Etiology | |
1 | Clinical features |
| Â | (a) Insidious early onset of cognitive, perceptual and motor symptoms in the absence of corresponding focal vascular lesions (infarct or small vessel disease) on brain imaging or history of vascular events. |
| Â | (b) Early and prominent movement disorder suggestive of Lewy body disease or other alpha-synucleinopathy or other non-vascular movement disorder |
| Â | (c) Features strongly suggestive of another primary neurological disorder sufficient to explain the cognitive impairment. |
2 | Neuroimaging |
| Â | (a) Absent or minimal cerebrovascular lesions on CT or MRI |
3 | Biomarkers (a) The presence of biomarkers of Alzheimer’s disease, dementia with Lewy bodies, or other disease related to cognitive decline. |
