American Board of Internal Medicine (ABIM) Certification Practice Exam

What do clinical criteria for diagnosing vascular neurocognitive disorder require in addition to evidence of cognitive disorder?

1. Family history of dementia

2. Evidence of a previous clinical stroke

3. Neuropsychological testing

4. Cerebrospinal fluid analysis

The correct answer is: Evidence of a previous clinical stroke

The correct answer is that clinical criteria for diagnosing vascular neurocognitive disorder require evidence of a previous clinical stroke. This is because vascular neurocognitive disorder is specifically characterized by cognitive impairment that is a direct result of cerebrovascular disease. The diagnosis hinges on a clear connection between cognitive deficits and the presence of vascular lesions or a history of stroke, which indicates that the cognitive decline is not solely due to neurodegenerative processes but rather linked to vascular factors that affect brain health. In the context of this disorder, understanding the vascular contributions to cognitive impairment is critical, as it differentiates vascular neurocognitive disorder from other causes of cognitive impairment such as Alzheimer’s disease. Examining the individual’s history for clinical strokes or other vascular risks helps establish that the cognitive dysfunction has a vascular origin, aligning with the clinical framework recommended in the diagnostic criteria. Other options, like a family history of dementia, while potentially relevant in assessing risk, do not provide direct evidence of a vascular etiology for the cognitive disorder. Neuropsychological testing is useful for determining the nature and extent of impairment but does not establish the vascular link required for this diagnosis. Similarly, cerebrospinal fluid analysis could rule out other pathologies but is not specifically required for the diagnosis of vascular neuroc