Dementia: the importance of clinical evaluation, autopsy confirmation, and research.

Because of the increasingly elderly population, dementia is a major public health problem, currently affecting over 50,000 Oklahomans at an approximate cost of one billion dollars annually. The marked overlap in symptomatology between Alzheimer's disease and other primary central nervous system degenerations makes antemortem diagnosis based on a clinical assessment tentative at best, with error rates of 25% commonly reported. Accurate diagnosis is of vital importance in improving our understanding of these illnesses, evaluating potential therapies, and providing appropriate genetic counseling to family members. Direct neuropathologic examination at autopsy is currently the only reliable method for assuring accurate diagnosis and should be undertaken in all demented patients.