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April 1984

Alzheimer's Disease: A Single Entity?

Author Affiliations

800 Massachusetts Ave Arlington, MA 02174

Arch Neurol. 1984;41(4):362. doi:10.1001/archneur.1984.04050160024005

To the Editor.  —The question of senile v presenile dementia as two different entities or just one disease (Alzheimer's) was reexamined recently in a article by Seltzer and Sherwin.1 The authors proposed splitting Alzheimer's disease into two different types. Type 1 would be characterized by early onset, early presence of language disorder, and preponderance of left-handers in this cohort, while type 2 would be just the reverse. The authors proposed a special vulnerability of the left hemisphere in the "presenile group" to explain the clinical phenomenon.It seems that the data presented can be used to reach exactly the opposite conclusion, namely, that there is no selective vulnerability of the left hemisphere in patients with Alzheimer's disease. The counterargument could run as follows: Let us assume Alzheimer's disease is a diffuse, global process affecting both hemispheres about equally. One would expect to see global functions such as abstract

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