REVISED international diagnostic criteria have been introduced for vascular cognitive impairment and dementia (VCID), aiming to standardize assessment and improve consistency across clinical and research settings. The updated VasCog-2-WSO criteria incorporate the latest scientific advances and represent a consensus developed through extensive international collaboration.
The revision builds on the original VasCog criteria published in 2014, which offered one of the most comprehensive approaches to VCID diagnosis at the time. Since then, rapid progress in neuroimaging and biomarker research has necessitated an updated framework. To address this need, the VasCog working group conducted an online Delphi survey in 2023, involving 70 invited experts from diverse global regions. Each round required a minimum 75% agreement threshold to establish consensus.
Between 49 and 54 experts participated in three survey rounds, ultimately endorsing a set of criteria that cover preclinical, mild, and major levels of vascular cognitive impairment under the umbrella term VCID. The group also reached consensus on incorporating novel neuroimaging techniques and fluid biomarkers into research guidelines, recognizing their growing role in early and precise diagnosis.
Importantly, the World Stroke Organization (WSO) has endorsed the updated criteria, now formally named the VasCog-2-WSO criteria. This endorsement strengthens their status as an international reference point and highlights their potential to align diagnostic practice across specialties and regions.
The VasCog-2-WSO criteria are expected to provide clinicians and researchers with clear operationalized guidance, reducing variability in diagnosis and enabling more reliable patient assessment. By integrating contemporary biomarker science with clinical expertise, the updated framework reflects the growing emphasis on early detection and standardized classification of VCID, a major cause of cognitive decline and dementia worldwide.
Reference: VasCog-2-WSO Criteria Consortium; Sachdev PS et al. Revised Diagnostic Criteria for Vascular Cognitive Impairment and Dementia-The VasCog-2-WSO Criteria. JAMA Neurol. 2025. doi: 10.1001/jamaneurol.2025.3242
