Background The diagnosis of dementia requires both memory loss and at
least one other type of cognitive impairment. The natural history of p
atients with severe memory loss but no other type of cognitive impairm
ent is poorly understood. We studied progression to dementia in patien
ts with isolated memory loss. Methods From a registry of 811 patients
with cognitive complaints, 21 patients with severe isolated memory los
s of unknown cause were identified and followed up for a mean of 48 mo
nths. A comparison group of 198 patients on the same register was iden
tified 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. Findings 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 t
he 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 neuropsych
ological tests did not predict which patients would progress to dement
ia. Interpretation Patients with severe isolated memory loss have an i
ncreased risk of developing dementia and should be closely followed-up
.