VSRAD utility as a screening tool for unrecognized cognitive dysfunction of elderly patients in diabetic outpatient clinics: Multi-center retrospective exploratory study.

Abstract

AIMS/INTRODUCTION\nAn efficient screening strategy for identification of cognitive dysfunction remains a clinical issue in management of elderly adults with diabetes. A magnetic resonance imaging (MRI) voxel-based specific regional analysis system for Alzheimer s disease (VSRAD) has been developed as an automated brain morphometry system that includes hippocampus. We conducted a multi-center retrospective study to evaluate the utility of VSRAD for screening cognitive dysfunction in diabetic outpatient clinics.\n\n\nPATIENTS AND METHODS\nWe enrolled patients with diabetes aged over 65 years who underwent brain MRI scans for the purpose of medical check-up between November 2018 and May 2019. Patients who were already suspected or diagnosed with mild cognitive impairment (MCI) and/or dementia as well as those with a history of cerebrovascular disease were excluded.\n\n\nRESULTS\nA total of 67 patients were enrolled. Five patients were diagnosed with MCI or dementia (clinical cognitive dysfunction). Patients with clinical cognitive dysfunction showed significantly higher Z-score in VSRAD analysis (2.57± 0.47 vs. 1.15± 0.55, p < 0.01). The sensitivities and specificities for diagnosis of clinical cognitive dysfunction were 80% and 48% for MMSE, 100% and 89% for Z-score, and 100% and 90% for the combination of MMSE score and Z-score, respectively.\n\n\nCONCLUSIONS\nVSRAD analysis can distinguish patients with clinical cognitive dysfunction in the elderly with diabetes and also demonstrates reasonable sensitivity and specificity compared with MMSE alone. Thus, VSRAD analysis can be useful for early identification of clinical cognitive dysfunction in the elderly with diabetes.