Neurodegenerative diseases have traditionally been defined as clinicopathological entities. Although this has been a productive paradigm in terms of the development of treatment strategies, molecular genetic approaches have revealed that there is overlap between different entities in pathogenic mechanisms. In this article, it is argued that neurodegenerative disease should also be thought of as the consequences of sequential biochemical processes, and that some parts of these processes appear to operate in more than one disease entity. Defining these pathways and, in particular, developing an appreciation of the commonalities between different diseases, should aid in the development of therapies that are effective in several diseases.