Cognitive dysfunction in
Alzheimer's disease may lead to accidental deaths in the elderly. Neuropathological diagnosis of the disease is, therefore, an important issue in forensic autopsy to determine the causal relation to accidents. To evaluate the suitability of the current histopathological diagnostic criteria for
Alzheimer's disease by Khachaturian and Mirra et al. in elderly persons dying from accidents and coming for forensic autopsy, we studied the brains of nine demented and 12 non-demented persons by
silver stain and immunohistochemistry. When the density of
senile plaque was applied to the criteria, only four out of nine demented persons met the criteria for definite
Alzheimer's disease. The demented persons had significantly higher density of diffuse plaque and higher frequencies of
amyloid angiopathy, neurofibrillary tangle and neuropil thread than the non-demented persons. These results indicated that the current diagnostic criteria do not always diagnose
Alzheimer's disease in forensic autopsy of elderly persons with fatal accident. The presence of abundant diffuse plaque, neurofibrillary tangle,
amyloid angiopathy and neuropil thread may help to diagnose
Alzheimer's disease in forensic autopsy.