Episodic memory in aging: neurocognitive bases and clinical implications of the distinction between hippocampal and frontal patterns.

Abstract

Episodic memory is one of the cognitive domains most vulnerable to age-related changes and the early stages of neurodegenerative syndromes. In Brazilian clinical practice, however, the interpretation of memory performance frequently remains restricted to the quantitative analysis of delayed recall, without adequate consideration of the underlying neurocognitive mechanisms. This study aimed to critically examine the neurobiological foundations of the distinction between hippocampal consolidation deficits and executive retrieval impairments mediated by prefrontal circuits, discussing their diagnostic and gerontological implications. This integrative narrative review is grounded in recent national and international literature (2019-2024) and integrates evidence from neuroimaging, theoretical models of memory, and clinical data relevant to aging. Differentiating hippocampal consolidation deficits from executive retrieval impairments, integrated with the assessment of functional capacity, is proposed as a clinically actionable, mechanism-based framework for improving diagnostic accuracy in aging within heterogeneous sociocultural contexts such as Brazil.