The controversy concerning the concept ‘alcoholic dementia’ is reviewed in brief. Evidence from neuroradiological and neuropathological studies contribute little to the solution of this controversy, if dementia is considered as a clinical syndrome. From clinical descriptions it can be concluded that a sub-population of alcoholics suffers from a syndrome typified by psychologic disturbances other than amnesia alone. These patients fulfill the criteria for the syndromal diagnosis of ‘dementia’.

The nosologic concept of ‘alcoholic dementia’ implies a direct neurotoxic effect of alcohol and it raises questions concerning pathogenetic mechanisms which can not be answered. The DSM-III-R category ‘dementia associated with alcoholism’ represents a solution for this controversy, because it gives a correct and complete (radically syndromal) clinical description without making assumptions on the relative contribution of multiple factors causing cognitive disturbances in alcoholics.