Memory loss

Introduction
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By Linda A Hershey MD PhD, Ferenc Deak MD PhD, and Calin I Prodan MD

Memory loss is also known as or subsumes Anterograde amnesia, Retrograde amnesia, and Short-term memory loss. -ed.

In this article, the authors provide an overview of memory loss and its most common presentations in the clinical setting (mild cognitive impairment, Alzheimer disease, vascular dementia, dementia with Lewy bodies, Wernicke-Korsakoff syndrome, and chronic traumatic encephalopathy). Risk factors for mild cognitive impairment are reviewed, along with lifestyle changes that have been suggested to slow progression from mild cognitive impairment to dementia.

Key Points

  • Several drugs with anticholinergic activity can cause reversible memory loss in younger subjects, but in older patients these drugs can produce what looks like a dementing illness. For this reason, tricyclic antidepressants, first-generation antihistamines, and bladder antimuscarinic drugs should be avoided in those who are over 65.
  • Chronic traumatic encephalopathy causes early memory loss in boxers, football players, and war veterans. The neurofibrillary tangles and extracellular plaques in the brains of these patients at autopsy are similar to those seen in the brains of Alzheimer disease patients. Significantly more changes in subcortical white matter are seen in cognitively impaired retired football players compared to age-matched controls.
  • There is a link between physical activity and cognitive dysfunction in Alzheimer disease, especially when regular physical activity is employed early in the disease process. Experiments in animal models of Alzheimer disease have shown that physical activity improves spatial learning and reduces brain levels of markers of oxidative stress.
  • Aggressive treatment of vascular risk factors in patients with Alzheimer disease without cerebrovascular disease has been shown to significantly slow cognitive decline for at least 2 years.

In This Article

Introduction
Historical note and nomenclature
Clinical manifestations
Clinical vignette
Localization
Pathophysiology
Epidemiology
Differential diagnosis
Diagnostic workup
Prognosis and complications
Management
Outcomes
References cited
Contributors