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1） Ichimiya Y: Alzheimer’s disease, 9-30, Clinical Practice of Dementia: Current Treatment Strategy and Cases, Medical Science International (Tokyo), 2013 (in Japa-nese) 2） Kosaka K, Oyanagi S, Matsushita M: Presenile dementia with Alzheimer-, Pick- and Lewy body changes. Acta Neuropathol, 1976; 36: 221-233. 3） Kitamoto T, Iizuka R, Tateishi J: An amber mutation of prion protein in Gerstmann-Sträussler syndrome with mutant PrP plaques. Biochemical and Biophysical Research Communications, 1993; 192: 525-531. 4） Collinge J: Prion disease. 404-415, New Oxford Text-book of Psychiatry, vol.1, Gelder MG, Lopez-Ibor Jr JJ, Andreasen NC, edit. Oxford university press (Oxford), 2000. 5） Ichimiya Y, Kosaka K: Diffuse Lewy body disease, 34-35, Clinical Atlas of Senile Dementia, edited by Ohtomo H, Hirai S, Medical Review (Tokyo), 1992 (in Japanese)444published at that time(Clinical Atlas of Dementia, 1992)5). In this book, Alzheimer’s disease is the first item in the table of contents, followed by vascular dementia, Pick’s disease, and Creuzfeldt-Jacob disease(CJD). Dementia with Lewy bodies appears at the end of the list after CJD which occurs in 1 in 1 million people. In these day, dementia with Lewy bodies appear after Alzheimer’s disease at the list. However, in those days it was regarded as a rare disease that was difficult to diagnose.In both cases presented above, a definitive diag-nosis was made through intervention of specialists from the network of Prof. Reiji Iizuka. Looking back on each patient’s medical history after the defini-tive diagnosis was obtained at autopsy, I could see key point for the diagnosis, which made me realize the importance of carefully analyzing clinical symp-toms and obtaining pathological diagnosis.ConclusionIn today’s clinical practice of dementia, various diagnostic image analysis methods are available for clinical diagnosis. However even when some case without dementia is diagnosed clinically, protein deposition is detected by amyloid imaging in the case. Nevertheless, the rate of autopsy is decreasing. We need to recognize again the importance of neuropathological examination at autopsy by following and respect once again to the two autopsy cases described above. They taught me the importance of paying careful attention to signs and symptoms and performing autopsies to final diagnosis, and this knowledge became the corner-stone of my clinical practice.I would like to express my deep gratitude to Hideoki Ogawa, M.D., Ph.D., the CEO of the Juntendo University, for his superb guidance on my clinical practice at the university, and to all people at the university, including my superiors, colleagues, and junior physicians at the department of psychiatry, who have supported me in various ways.AcknowledgmentReferences