In connection with the increase in the proportion of the elderly population, the multifaceted adverse significance of Alzheimer’s disease has recently been widely discussed, including its role as a cause of death. However, not always obvious influence of this disease on vital functions dictates the need for a differentiated methodological approach in this matter. The authors consider the differences in the effects of generally accepted variants of the course of Alzheimer’s disease on the prognosis of patients, as well as the fact that clinically and morphologically mixed forms of this pathology with cerebrovascular disease are increasingly detected, which in turn leads the complications of the latter to be a cause of death in respective cases. The general principles of the approach to solving the issue of the cause of death in elderly and senile people under the combined effect of the described cerebro-atrophic changes are formulated. At the same time, a sequence of arguments is proposed to consider Alzheimer’s disease as the cause of death.