Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
To the Editor.—In their Consensus Statement
on Alzheimer disease, Dr Small and colleagues1
contend that the diagnosis of Alzheimer disease must be primarily one of inclusion,
not exclusion. We believe it is the opposite.
We concur that the diagnosis of the dementia syndrome is primarily one
of inclusion. But once the clinician decides that a patient has dementia,
the clinical diagnosis of Alzheimer disease remains primarily one of exclusion.
Specifically, the Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition2 explains
that the diagnosis of Alzheimer disease will be established only after excluding
other causes of the dementia. On the other hand, Small et al1
give no further explanation to support their contention.
Ania BJ, Suarez-Almenara JL. Consensus Statement on Alzheimer Disease. JAMA. 1998;279(9):655-656. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-9-jbk0304