The variable topography of Alzheimer type changes in senile dementia and normal old age.

Alzheimer neurofibrillary changes and senile plaques were found in a variety of distribution patterns and intensities in 50 brains of patients older than 73 years who had been carefully examined for signs of organic dementia in a geriatric unit. As noted by earlier observers, the severity of dementia usually corresponded to the intensity of morphologic changes. In 2 patients, clinically identical with other demented subjects, the neocortex was spared and changes were confined to the hippocampus. The same pattern was found in 2 patients with less severe dementia. No patients with isolated temporal lobe changes could be clinically identified as having so-called 'simple senile dementia'.