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The fact that Alzheimer dementia is the sixth leading cause of death in adults aged 65 years or older in the United States  requires that the forensic pathologist, clinician, and medicolegal death investigator be familiar with the clinical manifestations of dementia and the appropriate postmortem evaluation for definitive classification. It has been shown that dementia, in general, is under-reported on death certificates , and its contribution to death may not be well-recognized.
A complete forensic autopsy includes examination of the brain. When the decedent is elderly, the procedures for the macroscopic examination and the decisions about selecting areas for microscopic examination follow the same general principles that guide other forensic cases. In addition, however, the pathologist should also be able to recognize incidental age-related changes and to understand how the presentation of different disease processes may vary in the geriatric population.