Differential diagnosis of memory loss

Symptom	Usual cause	Examples
Gradual onset of short-term memory loss (ie, loss of memory for recent events) and functional impairment in more than one domain: Executive function (finances, shopping, cooking, laundry, transportation) Basic activities of daily living (feeding, dressing, bathing, toileting, transfers)	Dementia	Alzheimer disease, Parkinson dementia, Lewy body dementia, frontotemporal dementia, alcohol-related dementia, Creutzfeldt-Jakob disease
Stepwise, sudden deterioration in cognition; episodes of confusion, aphasia, slurred speech, focal weakness	Cerebrovascular disease	Vascular dementia, multi-infarct dementia, Binswanger dementia (subcortical dementia)
Acute cognitive impairment with clouded sensorium; difficulty with attention; may have hypersomnolence	Delirium	Hypo- or hyperglycemia, hypo- or hypernatremia, hypoxemia, anemia, intermittent cerebral ischemia, thyrotoxicosis, myxedema, alcohol withdrawal, sepsis, drugs (especially cholinergics, benzodiazepines, etc)
Complains of memory loss, decreased concentration, impaired judgment, feels worse in morning and hopeless	Depression	Minor depression, dysthymic disorder, major depression, pathologic grief reaction

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