American Board of Internal Medicine (ABIM) Certification Practice Exam

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For a diagnosis of Mild Cognitive Impairment, which of the following is not a diagnostic criterion?

  1. Subjective memory complaints

  2. Objective cognitive impairment

  3. Significant social impairment

  4. Diminished independence in daily activities

The correct answer is: Significant social impairment

In the diagnosis of Mild Cognitive Impairment (MCI), significant social impairment is not a diagnostic criterion. MCI is characterized primarily by noticeable cognitive decline that is greater than expected for an individual’s age but does not significantly interfere with daily life or independence in activities. Subjective memory complaints are important because they represent the patient's own perception of memory issues, which often accompany the cognitive decline seen in MCI. Objective cognitive impairment is confirmed through standardized tests that demonstrate deficits in cognitive function, distinguishing MCI from normal aging. While individuals may experience some decreased independence in daily activities, this is not a defining criterion for MCI; rather, the hallmark of MCI is that individuals often retain their independence despite cognitive changes. In contrast, significant social impairment would suggest a more advanced cognitive disorder, such as mild dementia, where the impact on social functioning becomes pronounced, indicating a level of cognitive decline that surpasses MCI. Thus, the absence of significant social impairment is critical to maintain the diagnosis of MCI.