neurologic disorders
Memory Loss
Key Points
Memory loss and dementia are common in older adults and are common sources of worry for them. Age-associated memory impairment is common, causing slowing, but not deterioration, of memory and cognition. Diagnose primarily based on clinical criteria, particularly mood, attention, presence of true memory loss, and effect on daily function. Promptly exclude possible reversible and treatable causes of dementia (certain types of stroke, depression, seizures, head trauma, brain infections, hypothyroidism, HIV infection, normal-pressure hydrocephalus, brain tumors, vitamin B12 deficiency, overuse of certain medications and substances including alcohol). A complete medication and substance use history is critical because sedating and anticholinergic drugs can cause memory loss that can be reversed by stopping the drug. If patients have neurologic abnormalities (eg, weakness, altered gait, involuntary movements), do MRI or CT. Self-reported memory loss is usually not due to dementia. Delirium and depression must be ruled out before diagnosing dementia. 