Semantic memory (SM) was investigated in six patients with probable Alzheimer's disease (AD) by on-line measurement of semantic priming in a lexical decision task, and off-line tests of comprehension. Detailed assessment was carried out on naming, name comprehension, and probes of semantic knowledge with a battery of 150 items. The patients performed normally on perceptual tests and displayed an item-specific loss of knowledge on the semantic tests. In a primed lexical decision task, greater semantic priming was found relative to age-matched normals. The priming was substantially greater for items with "degraded" representations as determined by the off-line tests. Lexical decision was also performed more slowly on these items. These unexpected results demand a reevaluation of the concepts of the lexicon and semantic memory structure and their possible alteration in dementia.