[Pathophysiology of senile dementia]

In recent years considerable progress has been made in our understanding of the pathophysiology of Alzheimer's dementia and dementia of Alzheimer's type. The disorder selectively affects cortical and subcortical neuronal systems. Especially affected are neurons which utilize acetylcholine or somatostatin as transmitter substance. Cortical somatostatin-positive neurons are reduced in number and many of those persisting exhibit morphological changes consistent with neuronal degeneration. Many neurons displaying tangles and plaques contain somatostatin after immunostaining. Thus, degeneration of somatostatin containing neurons appears to be an early and even critical event in the development of Alzheimer's dementia.