What is a defining characteristic of Korsakoff syndrome?

Korsakoff syndrome is a chronic neurocognitive disorder primarily associated with thiamine (vitamin B1) deficiency, often resulting from alcohol misuse or malnutrition. A defining feature of Korsakoff syndrome is the combination of irreversible impaired short-term memory and confabulation.

Individuals with this syndrome typically have significant difficulties with short-term memory, meaning they struggle to form new memories after the onset of the condition. They may state facts or events that they cannot remember accurately, leading to confabulation, which is the production of fabricated, distorted, or misinterpreted memories about themselves or the world without the intent to deceive. This occurs as they attempt to fill in gaps in their memory with information that may feel real to them, despite being inaccurate.

In contrast, while irrational behavior may appear in some cases due to underlying cognitive impairment, and impaired long-term memory is often observed in broader dementias, it is the specific combination of severe short-term memory impairment alongside confabulation that is particularly indicative of Korsakoff syndrome. Auditory hallucinations, while associated with other psychiatric conditions, are not characteristic of Korsakoff syndrome.