ALZHEIMER'S DISEASE: PROBLEMS CONCERNING ITS CONCEPT AND NATURE

Abstract

Knowledge of Alzheimer''s disease has, in the course of its evolution, suggested a close association with the process of ageing. However, the custom of describing it as premature senility of the brain is to be deprecated because there are causes of hysteresis other than senility. Alzheimer''s disease is a clinicopathological condition: the two striking pathological features, the argyrophilic plaques and the neurofibrillary alterations are independent processes and are found in conditions other than Alzheimer''s disease and sometimes together. When they coexist in cases which clinically are of another type (cerebral arteriosclerosis, dementia pugilistica, Down''s disease) one may speak of secondary Alzheimer changes. It is suggested that the term senile dementia should be used only in a clinical and provisional context until such time as a pathological diagnosis is established. Thus a patient with "senile dementia" may turn out to have cerebral arteriosclerosis, Alzheimer''s disease, dementia senilis simplex or presbyophrenic dementia.