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Hippocampal sclerosis (HS) is defined as severe gliosis and neuronal loss in the CA1 region of the hippocampus and in the subiculum, with a wide range of severity and distribution.1,2 Its prevalence in autopsy series of demented elderly individuals ranged from 0.4 to 26%2,3 and was 7.4% in an autopsy cohort of prospectively evaluated demented elderly subjects,4 whereas it is extremely rare in nondemented patients considered the “oldest old.” In a recent series of 528 consecutive autopsies from the University of California at Los Angeles, 34 subjects (6.4%) with and without dementia—9.9% of demented and 3% of nondemented ones—showed HS. It was observed in Alzheimer disease (AD), frontotemporal dementia (FTD), vascular dementia (VaD), and Creutzfeldt–Jakob disease.5 Age at death was greater in demented subjects with than in those without HS (81.8 ± 12.5 vs …
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