advanced
stage, with executive dysfunction as the
most prominent presentation in its early stage.
These results were consistent with neuropsychological
characteristics of VCI described in the literature17,18.
The multi-aspect cognitive impairments
of attention, orientation, and spatial perception
were observed in the stroke control
group, with response and selection efficiency being
slowed down due to the attention defect.
Moreover, mild VCI is characterized by prominent
efficiency impairments of executive function
and information processing capability19. We used
LOTCA to assess patients with stroke and no apparent
cognitive impairment, who were consistent
with characteristics of cognitive impairment.
LOTCA is a powerful tool to detect features of
cognitive impairment in VaD and VCIND, and
can be utilized to detect mild cognitive impairment
in the early stages. The sensitivity of this
method is higher compared with that of MMSE.
Therefore, LOTCA is a suitable alternative technique
to detect VCIND.
As suggested in the studies of multiple sclerosis20,
each cognitive domain should be examined
thoroughly to highlight a specific domain to
comprehensively and objectively evaluate cognitive
changes in VCI. The coverage of multiple
cognitive domains by LOTCA is compliant with
recommendations in20. The test items can target
specific cognitive domains, and assessment of
executive function is also included.
Conclusions
We demonstrate that LOTCA is capable of detecting
cognitive impairment earlier and more
comprehensively than MMSE. Patients with mild
VCI were able to complete LOTCA within approximately
30 minutes. This method can be
used to assess cognitive function of patients with
VCIND for early detection of dementia in the
clinical practice.