Progression to dementia in patients with isolated memory loss

• Published in: The Lancet (British edition) Vol. 349; no. 9054; pp. 763 - 765
• Main Authors: Bowen, James, Teri, Linda, Kukull, Walter, McCormick, Wayne, McCurry, Susan M, Larson, Eric B
• Format: Journal Article
• Language: English
• Published: London Elsevier Ltd 15.03.1997; Lancet; Elsevier Limited
• Subjects: Adult; Adult and adolescent clinical studies; Aged; Aged, 80 and over; Alzheimer Disease - diagnosis; Alzheimer Disease - etiology; Biological and medical sciences; Cognitive ability; Dementia; Dementia - diagnosis; Dementia - etiology; Dementia disorders; Disease Progression; Female; Follow-Up Studies; Humans; Life Tables; Male; Medical sciences; Memory; Memory Disorders - complications; Memory Disorders - diagnosis; Middle Aged; Neuropsychological Tests; Older people; Organic mental disorders. Neuropsychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk; Human; Evaluation; Nervous system diseases; Loss; Clinical form; Cardiovascular disease; Isolated system; Memory function; Differential diagnostic; Prevention; Association; Etiology; Selection criterion; Psychopathology; Cognitive Assessment Test; Comparative study; Dementia
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(96)08256-6

The diagnosis of dementia requires both memory loss and at least one other type of cognitive impairment. The natural history of patients with severe memory loss but no other type of cognitive impairment is poorly understood. We studied progression to dementia in patients with isolated memory loss. From a registry of 811 patients with cognitive complaints, 21 patients with severe isolated memory loss of unknown cause were identified and followed up for a mean of 48 months. A comparison group of 198 patients on the same register was identified with newly recognised cognitive complaints but without dementia or isolated memory loss (mean follow-up 31 months). We did a range of neuropsychological tests at intake. During follow-up, 48% (n=10) of patients with isolated memory loss developed dementia compared with 18% (n=36) of the comparison group. Life-table analysis showed the mean times to a diagnosis of dementia was 3·77 years (95% CI 2·99–4·56) and 5·96 years (5·60–6·31), respectively (p=0·01). The neuropsychological tests did not predict which patients would progress to dementia. Patients with severe isolated memory loss have an increased risk of developing dementia and should be closely followed-up.