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To the Editor.—
Dr Frank R. Freemon (Arch Neurol 33:658, 1976) has pointed out the close parallel between the results of investigating patients with progressive intellectual deterioration in Nashville Veterans Hospital and the National Hospital for Nervous Diseases, Queen Square, London. One of us has recently had the opportunity to study the outcome of investigation of another 43 patients thought to have presenile dementia this time in a general London undergraduate teaching hospital. The patients had been admitted under the care of psychiatrists, neurologists, or general physicians, after referral by family doctors.As the Table makes clear, the proportion of subjects found to have treatable conditions, definable though basically untreatable disorders, and cerebral atrophy of unknown etiology are again closely similar.The conclusion of our earlier study from a specialized neurological center was that full evaluation of these patients was warranted because of the high proportion of treatable causes and the