Last reviewed:December 2019
Last updated:May  2019



History and exam

Key diagnostic factors

  • presence of risk factors
  • memory loss
  • disorientation
  • nominal dysphasia
  • misplacing items/getting lost
  • apathy
  • decline in activities of daily living and instrumental activities of daily living (IADLs)
  • personality change
  • unremarkable initial physical examination

Other diagnostic factors

  • mood changes
  • poor abstract thinking
  • constructional dyspraxia
  • prosopagnosia
  • autoprosopagnosia

Risk factors

  • advanced age
  • family history
  • genetics
  • Down's syndrome
  • low IQ
  • traumatic brain injury
  • depression
  • female sex
  • elevated plasma homocysteine level
  • cerebrovascular disease
  • hyperlipidaemia
  • lifestyle (smoking, obesity, diet high in saturated fats, and alcohol consumption)
  • less than secondary school education
  • artificially sweetened soft drink consumption

Diagnostic investigations

Treatment algorithm


Assistant Professor of Psychiatry

Mount Sinai School of Medicine

New York



JN declares that she has no competing interests.

Dr Judith Neugroschl would like to gratefully acknowledge Dr Brandy R. Matthews, Dr Asif S. Bhutto, and Dr Julie K. Gammack, the previous contributors to this topic.

Peer reviewersVIEW ALL

Medical Director

Kings Harbor Multicare Center

New York



RJG declares that he has no competing interests.

Professor of Neurology

Department of Neurology/Alzheimer Center

VU University Medical Center


The Netherlands


PS declares that he has no competing interests.

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