The paper by Exley and Esiri¹(see p 877) reports a most unusual case, namely, a 58-year-old woman with a rapidly progressive, fatal dementing illness, who, at autopsy, shows dramatic β-amyloid deposition of cerebral cortical and leptomeningeal blood vessels, modest numbers of neurofibrillary tangles and Lewy bodies, and evidence of very high aluminium content in affected brain regions. Of particular interest is that she was among the 20 000 people who were accidentally exposed, in July 1988, to exceedingly high concentrations of aluminium in their water supply in the so-called “Camelford incident”. This is the first autopsy-documented case of Alzheimer’s disease-like neurodegeneration …