Table 5.

Diagnostic criteria for vascular cognitive impairment, and what separates them

Criteria	Cognitive requirement	Vascular requirement	Required link
DSM-5, major or mild vascular neurocognitive disorder	Decline in one or more domains, major or mild	Cerebrovascular disease on history, examination or imaging sufficient to account for the deficits	Either a temporal relationship to a cerebrovascular event, or prominent decline in complex attention and executive function
VASCOG 2014	Graded, permitting mild as well as major impairment	Specified imaging burden: a large-vessel infarct, a strategic single infarct, two or more lacunes outside the brainstem, or extensive confluent white matter lesions	Profile-based or temporal; the imaging threshold is explicit
NINDS-AIREN 1993	Dementia	Cerebrovascular disease on examination and imaging	Onset within three months of stroke, or abrupt deterioration, or stepwise progression

All three require both the cognitive deficit and the vascular lesion, and differ in how tightly they require the two to be linked. NINDS-AIREN demands a temporal or stepwise link and therefore performs poorly for the insidious small vessel disease that is the modal presentation described here. None apportions the vascular and degenerative contributions in mixed disease.