Markers of cognitive impairment in vascular cognitiva disorders (literature review)

This article presents an analysis of the clinical, neurophysiological, and neuroimaging features of mild to moderate cognitive impairment (CI) in vascular cognitiva disorders. The relevance of the study is due to the high prevalence of cognitive disorders of vascular origin, their significant impact on patients’ quality of life, and the need for their early and accurate diagnosis. The analysis is based on data from clinical scales, ultrasound duplex scanning of the brachiocephalic arteries, and magnetic resonance imaging (MRI) of the brain. Key markers of vascular and neurodegenerative damage were assessed, including the degree of arterial stenosis and occlusion, characteristics of atherosclerotic plaques, as well as neuroimaging signs such as leukoaraiosis, lacunar infarcts, brain tissue atrophy, and microbleeds. It is shown that the diagnosis of CI requires a comprehensive approach, in which the leading role is given to the objective assessment of cognitive functions using standardized scales and questionnaires. The most informative screening tools in clinical practice are the MoCA and Mini-Cog scales, which can detect both moderate and more pronounced cognitive impairments. The combined use of neuropsychological testing and neuroimaging methods improves diagnostic accuracy, helps clarify the origin of the cognitive deficit, and determines further patient management strategies.

1. Zakharov V.V. Diagnosis and treatment of vascular cognitive disorders. The Clinician. 2023;17(3):12–21. (In Russ.) DOI: 10.17650/1818-8338-2023-17-3-k694

2. Федин А.И. Диагностика и лечение хронической ишемии мозга. Consilium Medicum. 2016;18(2):8-12. Fedin A.I. Diagnosis and treatment of chronic cerebral ischemia. Consilium Medicum. 2016;18(2):8-12. (In Russ.) eLIBRARY ID: 26007007 EDN: VXCXAZ

3. Novikova M.S., Zakharov V.V. The impact of non-drug treatments on the quality of life of patients with non-dementia vascular cognitive impairment. Meditsinskiy sovet = Medical Council. 2023;(3):30-37. (In Russ.) DOI: 10.21518/ms2023-006

4. Lokshina A.B., Zakharov V.V., Grishina D.A., Koberskaya N.N., Mkhitaryan E.A., Posohov S.I., et al. Heterogeneity of the mild cognitive impairmentsyndrome (specialized outpatientservice data analysis). Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2021;13(3):34- 41. (In Russ.) DOI: 10.14412/2074-2711-2021-3-34-41

5. Gomzyakova N, Palchikova E, Tumova M, Kasyanov E, Sorokin M. Association of Anxiety and Depression with Objective and Subjective Cognitive Decline in Outpatient Healthcare Consumers with COVID-19: А Cross-Sectional Study. Consort Psychiatr. 2022;3(3):45-55. DOI: 10.17816/CP189

6. Yakupov E.Z., Zhamieva R.A. Subjective cognitive impairment — more questions than answers. Neurology Bulletin. 2021;53(2):71–80. (In Russ.). DOI: 10.17816/nb71485

7. Vakhnina N.V., Milovanova O.V., Grinyuk V.V. Neurological disorders in hypertensive patients. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2015;7(4):57-64. (In Russ.) DOI: 10.14412/2074-2711-2015-4-57-64

8. Eruslanova K.A., Matchekhina L.V., Dudinskaya E.N., Kotovskaya Yu.V., Gudkov D.A., Govorun V.M., et al. Lipid and glucose metabolism in centenarians: risk factors of cardiovascular diseases and frailty. Russian Journal of Geriatric Medicine. 2020;(4):294-304. (In Russ.) DOI: 10.37586/2686-8636-4-2020-294-304

9. VasCog-2-WSO Criteria Consortium; Sachdev PS, Bentvelzen AC, Kochan NA, Jiang J, Hosoki S, et al. Revised Diagnostic Criteria for Vascular Cognitive Impairment and Dementia-The VasCog-2-WSO Criteria. JAMA Neurol. 2025;82(11):1103-1112. DOI: 10.1001/jamaneurol.2025.3242

10. Cornelis E, Gorus E, BeyerI, BautmansI, De Vriendt P. Early diagnosis of mild cognitive impairment and mild dementia through basic and instrumental activities of daily living: Development of a new evaluation tool. PLoS Med. 2017;14(3):e1002250. DOI: 10.1371/journal.pmed.1002250

11. Lopez-Anton R, Santabárbara J, De-la-Cámara C, Gracia-García P, Lobo E, Marcos G, et al. Mild cognitive impairment diagnosed with the new DSM-5 criteria: prevalence and associations with non-cognitive psychopathology. Acta Psychiatr Scand. 2015;131(1):29-39. DOI: 10.1111/acps.12297

12. Petersen RC. Mild cognitive impairment as a diagnostic entity. J Intern Med. 2004;256(3):183-194. DOI: 10.1111/j.1365-2796.2004.01388.x

13. Tkacheva O.N., Yahno N.N., Neznanov N.G., Shport S.V., Shamalov N.A., Levin O.S., et al. Clinical guidelines «Cognitive disorders in the elderly and senile persons». S.S. Korsakov Journal of Neurology and Psychiatry. 2025;125(3 3):7 149. (In Russ.) DOI: 10.17116/jnevro2025125337

14. Yakhno N.N., Lokshina A.B., Zakharov V.V. Mild and moderate cognitive disordersin dyscirculatory encephalopathy. Neurological Journal. 2004;(2):30–35. (In Russ.)

15. Sachdev PS, Blacker D, Blazer DG, Ganguli M, Jeste DV, Paulsen JS, et al. Classifying neurocognitive disorders: the DSM-5 approach. Nat Rev Neurol. 2014;10(11):634-642. DOI: 10.1038/nrneurol.2014.181

16. Kang JM, Manjavong M, Jin C, Diaz A, Ashford MT, Eichenbaum J, et al. Subjective cognitive decline predictslongitudinal neuropsychological test performance in an unsupervised online setting in the Brain Health Registry. Alzheimers Res Ther. 2025;17(1):10. DOI: 10.1186/s13195-024-01641-2

17. Raimo S, Maggi G, Ilardi CR, Cavallo ND, Torchia V, Pilgrom MA, et al. The relation between cognitive functioning and activities of daily living in normal aging, mild cognitive impairment, and dementia: a meta-analysis. Neurol Sci. 2024;45(6):2427-2443. DOI: 10.1007/s10072-024-07366-2

18. Sepehry AA, Schultz IZ, Cohen DA, Greer S. From Subjective Cognitive Decline to Mild Cognitive Impairment to Dementia: Clinical and Capacity Assessment Considerations. Psychol. Inj. and Law. 2023;16:273–287. DOI: 10.1007/s12207-022-09456-y

19. Parfenov V.A., Silina E.V. Cognitive impairment in patients with chronic cerebral ischemia (discirculatory encephalopathy). Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2025;17(3):120–126. (In Russ.) DOI: 10.14412/2074-2711-2025-3120-126

20. Pilipovich A.A., Vorobeva O.V. Mild cognitive impairment: modern aspects of diagnostics and therapy. S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(11):124 130. (In Russ.) DOI: 10.17116/jnevro2020120111124

21. Cardoso S, Barros R, Marôco J, de Mendonça A, Guerreiro M. Different MMSE domains are associated to cognitive decline and education. Appl Neuropsychol Adult. 2024;31(4):533-539. DOI: 10.1080/23279095.2022.2041018

22. Carton C, Calafiore M, Cauet C, Messaadi N, Bayen M, Wyts D, et al. Montreal Cognitive Assessment (MoCA) use in general practice for the early detection of cognitive impairment: a feasibility study. BJGP Open. 2025;9(1):BJGPO.2024.0039. DOI: 10.3399/BJGPO.2024.0039

23. Larner AJ. Screening utility of the Montreal Cognitive Assessment (MoCA): in place of--or as well as--the MMSE? Int Psychogeriatr. 2012;24(3):391-396. DOI: 10.1017/S1041610211001839

24. Abayomi SN, Sritharan P, Yan E, Saripella A, Alhamdah Y, Englesakis M, et al. The diagnostic accuracy of the MiniCog screening tool for the detection of cognitive impairment-A systematic review and meta-analysis. PLoS One. 2024;19(3):e0298686. DOI: 10.1371/journal.pone.0298686

25. Park SH, Han KS. Isthe Alzheimer’s Disease Assessment ScaleCognitive Subscale Useful in Screening for Mild Cognitive Impairment and Alzheimer’s Disease? A Systematic Review. Curr Alzheimer Res. 2022;19(3):202-211. DOI: 10.2174/1567205019666220404104854

26. Wesnes K.A. An automated system for assessing cognitive function in any environment. Proceedings. 2005;5797. DOI: 10.1117/12.604372

27. Høiland K, Raudeberg R, Egeland J. The repeatable battery for the assessment of neuropsychologicalstatus(RBANS) and substance use disorders: a systematic review. Subst Abuse Treat Prev Policy. 2025;20(1):12. DOI: 10.1186/s13011-025-00640-2

28. Li C, Neugroschl J, Luo X, Zhu C, Aisen P, Ferris S, et al. The Utility of the Cognitive Function Instrument (CFI) to Detect Cognitive Decline in Non-Demented Older Adults. J Alzheimers Dis. 2017;60(2):427-437. DOI: 10.3233/JAD-161294

29. Farias ST, Weakley A, Harvey D, Chandler J, Huss O, Mungas D. The Measurement of Everyday Cognition (ECog): Revisions and Updates. Alzheimer Dis Assoc Disord. 2021;35(3):258-264. DOI: 10.1097/WAD.0000000000000450

30. Ionova TI, Frolova EV, Ovakimyan KV, Mkhitaryan E.A., Tkacheva O.N., Logunov D.L., et al. The use of the Mini-Cog, MMSE, and GPCOG tests in domestic clinical practice for the evaluation of cognitive disordersin elderly and senile patients: the results of a survey of experts’ opinions. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;123(7):55 64. (In Russ.) DOI: 10.17116/jnevro202312307155

31. Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a briefscreening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695-699. Erratum in: J Am Geriatr Soc. 2019;67(9):1991. DOI: 10.1111/j.1532-5415.2005.53221.x

32. Sachdev P, Kalaria R, O’Brien J, Skoog I, Alladi S, Black SE, et al. Diagnostic criteria for vascular cognitive disorders: a VASCOG statement. Alzheimer Dis Assoc Disord. 2014;28(3):206-18. DOI: 10.1097/WAD.0000000000000034

33. Rost NS, Brodtmann A, Pase MP, van Veluw SJ, Biffi A, Duering M, et al. Post-Stroke Cognitive Impairment and Dementia. Circ Res. 2022;130(8):1252-1271. DOI: 10.1161/CIRCRESAHA.122.319951

34. Kotova O.V., Zuykova N.L., Palin A.V., Frolova V.I., Gushanskaya E.V., Salyntsev I.V., et al. Psychopathological disordersin chronic cerebral ischemia: possibilities of prevention. Lechaschi Vrach. 2021;(5):22-26. (In Russ.) DOI: 10.51793/OS.2021.15.98.005

35. Webster-Cordero F, Giménez-Llort L. A Systematic Review on Subjective Cognitive Complaints: Main Neurocognitive Domains, Myriad Assessment Tools, and New Approaches for Early Detection. Geriatrics (Basel). 2025;10(3):65. DOI: 10.3390/geriatrics10030065

36. Сосудистые когнитивные расстройства. Терапия. 2025;11(3S):120–141. Vascular cognitive disorders. Therapy. 2025;11(3S):120–141. (In Russ.) DOI: 10.18565/therapy.2025.3suppl.120-141

37. Zakharov V.V. Depression in cerebrovascular diseases. Effektivnaya farmakoterapiya. 2014;(31):4–11. (In Russ.). eLIBRARY ID: 22474642 EDN: SXVDDB

38. Talwar P, Kushwaha S, Chaturvedi M, Mahajan V. Systematic Review of Different Neuroimaging Correlates in Mild Cognitive Impairment and Alzheimer’s Disease. Clin Neuroradiol. 2021;31(4):953-967. DOI: 10.1007/s00062-021-01057-7

39. Boreyko A.P., Kulakova T.D., Lukina S.F. Atherosclerotic Changes of Brachiocephalic Arteriesin Different Age Groups According to Sonography. Siberian Journal of Life Sciences and Agriculture. 2024;16(3):92-113. (In Russ.) DOI: 10.12731/2658-6649-2024-16-3-853

40. Dempsey RJ, Varghese T, Jackson DC, Wang X, Meshram NH, Mitchell CC, et al. Carotid atherosclerotic plaque instability and cognition determined by ultrasound-measured plaque strain in asymptomatic patients with significant stenosis. J Neurosurg. 2018;128(1):111-119. DOI: 10.3171/2016.10.JNS161299

41. Huston J 3rd, James EM, Brown RD Jr, Lefsrud RD, Ilstrup DM, Robertson EF, et al. Redefined duplex ultrasonographic criteria for diagnosis of carotid artery stenosis. Mayo Clin Proc. 2000;75(11):1133-1140. DOI: 10.4065/75.11.1133

42. Nosenko N.S., Nosenko E.M., Alemasova D.S., Dedy T.V. The evaluation of the hemodynamically significant stenosis of the carotid arteries: analyzing the results from the duplex scanning of vessels, from the computed tomographic and the transcatheter X-ray contrast angiography. Journal of Clinical Practice. 2025;16(1):7-15. (In Russ.) DOI: 10.17816/clinpract635680

43. Zubrikhina M.O., Abramova O.V., Yarkin V.E., Ushakov V.L., Ochneva A.G., Bernstein A.V., et al. Machine learning approaches to mild cognitive impairment detection based on structural MRI data and morphometric features. Cognitive Systems Research. 2023;78:87-95. DOI: 10.1016/j.cogsys.2022.12.005

44. Odinak M.M., Emelin A.Yu., Lobzin V.Yu., Vorobyev S.V., Kiselev V.N. Current capacitiesfor neuroimaging in the differential diagnosis of cognitive impairments. Neurology, Neuropsychiatry, Psychosomatics. 2012;(S2):51–58. (In Russ.) DOI: 10.14412/2074-2711-2012-2509

45. Preobrazhenskaya I.S., Naumenko A.A., Trofimova N.V. Modern approaches to treatment and rehabilitation of patients with vascular cognitive impairment. Doctor.Ru. 2016;4(121):30–38. (In Russ.). eLIBRARY ID: 26205653 EDN: WBLXPH

46. Voznyuk I.A., Zavadenko N.N., Kamchatnov P.R., Levin O.S., Parfenov V.A., Solovieva E.Yu., et al. Results of the round table: modern approaches to drug therapy of cognitive impairment in cerebrovascular pathology. S.S. Korsakov Journal of Neurology and Psychiatry. 2021;121(8):147 152. (In Russ.) DOI: 10.17116/jnevro2021121081147

47. Preobrazhenskaya I.S., Fantalis D., Abdyshova S.A., Kindarova A.A. Non-drug therapies for cognitive impairment. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2019;11(3S):68-77. (In Russ.) DOI: 10.14412/2074-2711-2019-3S-68