Alzheimer's Disease

In 1907, Alois Alzheimer, a German physician from Bavaria, published the case of one of his patients. The patient, Mrs. Auguste D., at the age of fifty-one years developed an unfounded jealousy regarding her husband. This behavioral change was followed closely by a subtle and slow decline in other cognitive abilities, including memory, orientation to time and to physical location, language, and the ability to perform learned behaviors. All of her difficulties gradually progressed in severity. Within three years, the patient did not recognize her family or herself, could not maintain her self-care, Eugenie Bonenfant, left, is a resident in Rhode Island's first assisted living community designed exclusively for people with Alzheimer's disease. The unit supervisor, Margaret Knight, visits, and she is surrounded by her own, familiar furniture. and was institutionalized. She died a short four and a half years after her illness began. Her brain was removed at autopsy. Using a novel (at the time) silver stain to highlight changes in brain sections, Dr. Alzheimer viewed the tissue under his microscope. He described what are now the pathologic lesions of the disease that bears his name: loss of neurons, senile plaques found in the brain substance but outside of the neurons, and neurofibrillary tangles found inside neurons.

Dr. Alzheimer's patient had developed dementia. Dementia is an acquired and continuing loss of thinking abilities in three or more areas of cognition (which include memory, language, orientation, calculation, judgment, personality, and other functions) severe enough that the individual can no longer function independently at work or in society. There is no decrease in level of consciousness. Early in the illness, physical strength is maintained, though later the individual may "forget" how to perform certain physical functions, such as using tools or utensils, dressing, or performing personal hygiene activities. Onset of dementia may occur over days, months, or years. Its course may be static or progressive. Causes of dementia, other than AD, include other neurodegenerative disease, central nervous system infection, brain tumor, metabolic disease, vitamin deficiency, and cerebrovascular disease.