[What is dementia? 3. The neuropathologist point of view]

It is the clinical examination, which allows the diagnosis of dementia. The neuropathologist identifying the markers of the various dementing disorders is able to add the name of a disease to the diagnosis of dementia. However, our present-day nosology, based on indirect evidences, might appear obsolete in the future, when the mechanism of the various types of dementia will be elucidated. There is probably no "normal lesion": any alteration is the consequence of the disease, which, however, might not be symptomatic, because the density of the lesions has not reached a threshold above which the first clinical signs appear. Neuropathology has been useful during the last decades in helping to identify the proteins involved in the pathogenesis of many neurodegenerative diseases. Most of these findings were made possible only thanks to post-mortem examination, more useful to-day than ever.