A final consideration concerns the role of neuropathology in the field of dementia. Since dementia is a pure clinical definition, can the pathological examination be considered a true gold standard in this field? By no means; neuropathology has a great role in defining the lesions present in patients with cognitive decline. However, we feel that we are far from finding the precise structural correlate of dementia in the brain. In many instances, dementia derives from a functional rather than from an anatomical alteration. In other instances, the discovery of cerebral lesions is not reflected in clinically evident alterations. Accordingly, the diagnosis of dementia should remain essentially clinical. Notwithstanding these facts, there is a tremendous need to descriptively and systematically study from the pathological viewpoint the types, extent, location, and possible coexistence of cerebral lesions in cases of cognitive decline. However, agreement should be reached regarding what lesions are to be considered as vascular. Neuropathologists are called upon to merge their efforts with those of clinicians and neuroradiologists to better define the vascular burden on the brain.