This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Contact me when this article is cited  Related Content  • Similar articles in JAMA

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

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.

Despite recent advances of molecular genetics in the field of Alzheimer disease,³ confirming Alzheimer disease clinically is still a risky business.

Basilio J. Ania, MD; José L. Suarez-Almenara, MD
Canarian Society for Geriatrics and Gerontology
Las . . . [Full Text of this Article]