Peran biomarka darah dalam diagnosis vascular cognitive impairment and dementia

Background: Diagnosis of vascular cognitive impairment and dementia (VCID) is still a global challenge due to varying and overlapping clinical manifestations, many comorbidities, stigma for normal aging, and other socioeconomic factors. Biomarkers can help in the diagnosis of dementia subtypes. Blood biomarkers are an easier and less invasive method; however, their role in the diagnosis of VCID is not well understood. Objective: This scoping review aims to synthesize the scientific evidence regarding the role of blood biomarkers in the diagnosis of VCID. Methods: A scoping review was performed to understand the role of blood biomarkers for the diagnosis of VCID based on the newest prospective cohort study, and was drawn from journal databases released between 2020–2025. Results: We found 2 main groups of potential VCID diagnostic biomarkers: there are biomarkers for cerebral small vessel disease (CSVD) and post-stroke cognitive impairment (PSCI). Biomarkers for CSVD consist of PlGF, IL-18, and GFAP; whereas, biomarkers for PSCI consist of endostatin, LMP2, pNfL, neopterin, kynurenine, vitamin B6, and neuroglobin. Each biomarker has an association with the development of VCID, but lacks the understanding of its role in monitoring disease progression, discriminative power, and therapeutic target potential. Conclusion: Even though several blood biomarkers have been found to have potential as diagnostic markers, all biomarkers still need further validation and head-to-head comparison before clinically applied. ABSTRAK Latar Belakang: Diagnosis vascular cognitive impairment and dementia (VCID) masih menjadi tantangan global karena manifestasi klinis yang variatif dan tumpang tindih, banyaknya komorbiditas, anggapan penuaan normal, dan faktor sosioekonomi lainnya. Biomarka dapat membantu dalam diagnosis subtipe demensia. Biomarka darah merupakan biomarka yang lebih mudah dan noninvasif, namun belum banyak diteliti perannya dalam diagnosis VCID. Tujuan: Scoping review ini bertujuan untuk mensintesis bukti-bukti ilmiah mengenai peran biomarka darah dalam diagnosis VCID. Metode: Scoping review dilakukan untuk mengetahui peran biomarka darah dalam diagnosis VCID berdasarkan penelitian kohort prospektif terkini dan diambil dari berbagai basis data jurnal yang diterbitkan pada tahun 2020–2025. Hasil: Ditemukan 2 kelompok biomarka yang potensial untuk diagnosis VCID, yaitu biomarka cerebral small vessel disease (CSVD) dan post-stroke cognitive impairment (PSCI). Biomarka CSVD terdiri dari PlGF, IL-18, dan GFAP, sedangkan biomarka PSCI terdiri dari endostatin, LMP2, pNfL, neopterin , kynurenine , vitamin B6, dan neuroglobin. Masing-masing biomarka memiliki hubungan dengan kejadian VCID namun belum diketahui dampak perubahan kadar terhadap progresivitas penyakit, peran dalam membedakan subtipe, dan potensi untuk menjadi target terapi. Kesimpulan: Meskipun beberapa biomarka darah telah memiliki potensi diagnosis, semua biomarka masih memerlukan validasi lebih lanjut dan komparasi langsung antarbiomarka untuk dapat digunakan pada praktik klinis.