Introduction: In Vietnam, Alzheimer’s disease (AD) and other dementias have become an increasingly important public health problem among the elderly. Achieving a diagnosis tool with high reliability and validity is essential. The Clinical Dementia Rating (CDR) is a global clinical scale with established diagnostic and severity-ranking utility that has been widely employed in epidemiological studies in an international context. Objective: The aims of this study were to establish the Vietnamese version of the CDR (V-CDR) and evaluate the feasibility, reliability, and validity of this version for diagnosing and classifying cognitive functions in the elderly. Method:One hundred and fifty-three elderly outpatients at a clinic of Cho Ray Hospital, Vietnam, were screened with the Mini Mental State Examination (MMSE) for potential cognitive impairment. All those who scored ≤26 points were included in the study and were subsequently remitted to the V-CDR and clinical assessment for diagnosis. Reliability was assessed through internal consistency (Cronbach α), intra- and interrater reliability (weighted κ). Concurrent and discriminative validity of the V-CDR were assessed. Results: The V-CDR had an excellent internal consistency for each of the 2 raters (Cronbach α 0.90 and 0.96) and excellent agreement in both intra- and interrater reliability (weighted κ 0.84 [95% CI 0.74–0.94] and 0.82 [95% CI 0.72–0.93], respectively). The sensitivity and specificity for detecting dementia were 93.6 and 100%, respectively. The positive and negative predictive value were 100 and 96.4%, respectively. The agreement of V-CDR and clinical assessment was excellent (weighted κ 0.94 [95% CI 0.88–0.99]). V-CDR was substantially better than MMSE at distinguishing between mild cognitive impairment and normal cognitive function (AUC = 0.957, 95% CI 0.893–1.000 vs. AUC 0.594, 95% CI 0.441–0.746). Conclusions: The V-CDR is a feasible, reliable, and valid instrument which should be used in clinical practice for diagnosing and classifying the different dementia stages in the elderly.

Global aging populations are facing increased prevalence of mild cognitive impairment (MCI) - the preclinical stage of dementia characterized by single/multi-domain neurocognitive decline that does not impair an individual's normal daily functioning. Asian populations are at increased risk of developing MCI and dementia, and many cases go undetected in Southeast Asia (SEA), resulting in increased burden on patients, caregivers and national healthcare systems. There is an urgent need for efficient and scalable diagnostic and management strategies across SEA. Our findings illustrate that current strategies are limited by insufficient resources and a lack of awareness, particularly in developing SEA nations. Strategies for improving the MCI landscape in SEA include increasing widespread community awareness and cognitive health screenings for individuals with a history of vascular risk factors, validation of traditional cognitive screening tests in the respective countries, greater access to blood-biomarker testing, and the development and validation of novel digitized diagnostics.

Background: Mini-Mental State Exam (MMSE) is widely used for the cognitive assessment in Alzheimer’s disease (AD), but its interpretation could be affected by acute medical conditions, depression, or anxiety. Conversely, brain magnetic resonance imaging (MRI) is an independent diagnostic tool to evaluate specific cerebral pathology. Many studies have investigated the correlation between MRI visual scales such as hippocampal atrophy and baseline MMSE in AD patients. However, the correlation between a comprehensive MRI visual scale and baseline MMSE in people with AD remains less well known. Method: We retrospectively collected records of outpatients diagnosed with probable AD according to DSM -5 criteria. The comprehensive visual rating scale (CVRS) was used to semiquantitatively measure structural changes and vascular lesions. The relationship between MRI changes and baseline MMSE was evaluated using Bayesian model averaging (BMA). Results: A total of 65 patients, among whom 21 (32.31%) had early-onset AD, were included. Lateral temporal atrophy, level of education, and late age at onset were the strongest independent predictors of baseline MMSE. Furthermore, hippocampal atrophy was only correlated with delayed recall, while temporal atrophy was correlated with orientation, attention, language, and visual-spatial items of the MMSE. The cerebral atrophy and small vessel lesions scores of the late-onset AD group were significantly higher than those of the early-onset group, despite negligible differences in education and MMSE. Conclusion: Our study suggests lateral temporal atrophy correlates with baseline MMSE scores in people with AD better than the hippocampal atrophy. Age-related atrophy and silent small vessel disease lesions may have negligible impact on AD patients’ cognitive impairment.

Background: In Vietnam, there has been, currently, no standardized tool for depression assessment for people with dementia (PWD). Cornell Scale for Depression in Dementia (CSDD) is a widely studied and used scale for PWD worldwide. Objectives: The aim of this study was to standardize the Vietnamese version of the CSDD (V-CSDD) in depression assessment in PWD through reliability and validity examination. Methods: V-CSDD was rated in terms of reliability and validity with gold standard regarding “major depressive episode” and “major depressive-like episode” of DSM-5. Cronbach’s α, ICC, exploratory factor analysis (EFA), and receiver operating characteristic analysis were performed. Results: V-CSDD was found to have a high internal consistency reliability (Cronbach’s α = 0.80), inter-rater reliability at sound ranking (ICC = 0.89; 95% CI = 0.81–0.94), maximum cut-off mark of 13 (sensitivity = 70%, specificity = 92%), and EFA, which suggested that V-CSDD may comprise 5 factors. Conclusions: Results indicate the V-CSDD to be a reliable and valid assessment and to be beneficial in classifying and diagnosing depression in dementia outpatients in clinical contexts.

Objective: Normative data of neuropsychological tests in the Vietnamese population is considerably lacking. We aim to evaluate the effects of age, education, and sex on the performance of common neuropsychological tests, and to generate normative data for these tests in cognitively normal Vietnamese adults. Method: Participants were recruited from two hospitals in Ho Chi Minh City, with inclusion criteria as follows: age ≥ 40 years, normal cognition and function, and Mini-Mental State Examination (MMSE) scores ≥ 26. Neuropsychological tests were administered in a paper-and-pencil format, including the CERAD Word List, Trail Making Tests, Digit Span, Animal Naming, and Clock Drawing Test. Effects of age, education, and sex on test performance were evaluated using multiple linear regression analyses. Normed scores were reported as regression-based and discrete norms tables. Results: Participants included 385 cognitively normal Vietnamese, with age 61.4 ± 10.9 years (range 40 – 89), female 56%, who were relatively highly educated (42% attended college and beyond, 36% attended high school or equivalent institutions, 22% had less than high school education), and had MMSE scores 27.8 ± 1.0. Trail Making Test Part B was completed within 300 s by only 204/385 (53%) participants. Regression analyses demonstrated significant associations between age and education with performance on all or most tests, and between sex and all CERAD Word List measures and Clock Drawing Test. Conclusions: The present work provides the first known normative data for a relatively comprehensive neuropsychological battery in Vietnamese adults. Performance on all tests was significantly influenced by age and education.