Wednesday, May 20, 2009

The Story of The First Alzheimer's Patient

In November 1901, German psychiatist Alois Alzheimer encountered a woman named Auguste Deter (Auguste D, as she came to be known) who had been brought to Alzheimer's Frankfurt clinic by her husband.

According to the husband, the couple had been harmoniously married since 1873, but he had recently noticed a gradual decline in his wife that went beyond short- and long-term memory loss. At the relatively young age of 51, she had become disturbingly absent-minded, making obvious mistakes in food preparation, neglecting her housework, stashing objects in nooks and crannies around their apartment, wandering aimlessly from room to room, and suffering from intense bouts of jealousy and paranoia.

As the months went by, thoughts of Auguste D. stayed with Dr. Alzheimer. He recognized that Auguste D.'s case could prove to be of great scientific importance because of her young age. At fifty-one, she was exhibiting the behavioral symptoms that one might expect to observe in a dementia patient in their seventh, eighth, or ninth decade.

The dilemma for Alzheimer and his colleagues was the same as it is today: Did Auguste D. (and others like her) have a specific disease separate from normal aging? Or were their brains simply moving quicker along the continuum of aging and experiencing the symptoms of senility a bit more rapidly than others? This quandary puzzled Dr. Alzheimer for years to come.

In 1906, Auguste D. passed away. Dr. Alzheimer performed an autopsy, finding a high volume of senile plaques and neurofibrillary tangles in the tissue of her brain. In November of that year, Dr. Alzheimer delivered a now famous lecture to the Assembly of Southwest German Psychologists in Tübingen. Alzheimer stood before nearly ninety of his colleagues in this lecture theatre and reported on the case of Auguste D, interspersing his lecture with wonderfully-drawn slides of the plaques and tangles found in and on Auguste D's brain in post mortem investigation.

Until the day he died, Alzheimer was reluctant to label the condition he observed in Auguste D. as a specific disease. Nevertheless, his boss, Emil Kraepelin, the authority on psychiatry in Europe, published an account of Alzheimer's disease on in the 8th Edition of his definitive Psychiatry textbook. And so, in 100 years we've gone from having one Alzheimer's disease patient, Auguste D., to having more than 25 million worldwide.

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