An accompanying letter to the editor (p 304) provides another illustration of the malignancy of Alzheimer disease, a phenomenon well known to neurologists. Katzman and Karasu1 estimate that the senile form of Alzheimer disease may rank as the fourth or fifth most common cause of death in the United States. Yet the US vital statistics tables do not list "Alzheimer disease," "senile dementia," or "senility" as a cause of death, even in the extended list of 263 causes of death.
The argument that Alzheimer disease is a major killer rests on the assumption that Alzheimer disease and senile dementia are a single process and should, therefore, be considered a single disease. Both Alzheimer disease and senile dementia are progressive dementias with similar changes in mental and neurological status that are indistinguishable by careful clinical analyses.2,3 The pathological findings are identical—atrophy of the brain, marked loss of neurons