LETTERS: Exquisiteness of senile dementia

From Dr T. H. Turner Sir: John Shepherd's article "Forget Alzheimer's - Saunders" (30 December) does not distinguished between Alzheimer's disease and senile dementia. Mr Saunders's denial that he suffered from the latter is quite acceptable.

The term "pre-senile dementia" describes merely the clinical presentation of intellectual decline in those aged under 65 years. This condition has many causes, the most common being Alzheimer's disease, which can only be confirmed by post-mortem analysisof the brain.

Fortunately for Mr Saunders, depressive symptoms may mimic those of pre-senile dementia, the correct diagnosis only emerging over time. Depression is treatable and recovers (thus being termed "pseudo dementia"), while the demented continue to decline. The frequency of this mis -diagnosis absolves the doctor from any blame.

Thus "pre-senile dementia" was an understandable error, cannot be falsified, and was exquisitely suitable for someone in Mr Saunders' predicament.

Yours faithfully, T. H. TURNER Consultant Psychiatrist City and East London Family and Community Health Services Hackney Hospital London, E9

5 January