The concentrations of 17 elements in the hair and nails of 180 Alzheimer's disease (AD) and control subjects have been determined by instrumental neutron activation analysis (INAA). Comparisons of trace element levels of properly matched AD and control groups revealed significant imbalances in the concentrations of six elements (Br, Ca, Co, Hg, K, and Zn) between disease and control groups. It is noteworthy that each of these has previously been shown by our group, or others, to be altered in some AD brain region(s). Geometric means for each element in both hair and nails of AD and control subjects are presented, and significant differences noted. The significance of these alterations with regard to the possible role of trace elements in the etiology of AD is discussed.