Age-Associated Memory Impairment: Proposed Diagnostic Criteria and Measures of Clinical Change - Report of a National Institute of Mental Health Work Group

There is a widely held belief that the ability to remember certain types of information declines in many healthy individuals during the later decades of adult life, and this belief is supported by a large and well-developed body of empirical data (e.g., Craik, 1977; Flicker, Ferris, Crook, Bartus, & Reisberg, 1985; Fozard, 1985; Poon, 1985). Despite widespread recognition of the phenomenon, there is no generally accepted diagnostic term to describe individuals who experience such loss. There are also no precise diagnostic criteria for distinguishing these individuals from persons who have experienced no such loss and from those who experience memory loss likely to be associated with specific disease states. Terms such as benign senescent forgetfulness (BSF; Kral, 1962, 1966) have been used in the scientific literature, but these terms are often semantically inappropriate, imprecisely defined, and intended to describe a particular subset of older people with memory impairment. This lack of agreement on terminology and specific diagnostic criteria poses problems both for clinicians communicating with patients and for investigators attempting to study the clinical phenomenon and develop effective therapeutic interventions. Research into possible pharmacologic treatments for memory loss requires that agreement be reached on clearly specified diagnostic criteria (Leber, 1983). We report diagnostic terminology and specific research diagnostic criteria proposed by a National Institute of Mental Health (NIMH) work group(1) to describe the memory loss that may occur in healthy, elderly individuals in the later decades of life. These are presented to facilitate communication among investigators and stimulate research into the epidemiology, clinical characterization, and treatment of later-life memory loss. Both the diagnostic terminology and criteria are presented with the expectation that modifications and revisions will occur as further research is conducted and as the views of clinicians and researchers are expressed.