Tuesday Tips for Caregivers – A Short History on Alzheimer’s Disease

Tuesday Tips for Caregivers – A Short History on Alzheimer’s Disease

A Short History of Alzheimer’s: First Reported Case and Incidence Over Time

Dementia is a general term describing degenerative neurological conditions. Alzheimer’s is a kind of dementia that causes the brain to atrophy and brain cells to die. It is a condition that usually affects people over the age of 65. While other forms of dementia exist, Alzheimer’s disease is characterized by the specific plaques (beta-amyloid) and tangles (tau proteins) which negatively impact neurons in the brain. Researchers are working towards finding a cure. This blog talks briefly about the first patient diagnosed with this disorder, and the significant implications this diagnosis had over time.

The first patient with Alzheimer’s

In Frankfurt, Germany, 1901, a 51 year old woman by the name of Auguste D. was admitted to medical asylum because of strange symptoms she began experiencing. A psychiatrist named Alois Alzheimer documents Auguste D.’s background saying that, until 1901, she was fine until she developed seemingly random bouts of paranoia and began accusing her husband of having an affair. She also exhibited (now common) symptoms of Alzheimer’s, like difficulty remembering things, having trouble dealing with money, and making mistakes when doing home-based tasks. Dr. Alzheimer documented in detail his observations of her and, after her death in 1904, he requested to have a look at her brain.[1]

By looking at her brain post-mortem, he wanted to understand its neurological features to identify what caused her illness. He documented, in detail, certain “fibrils” that existed where previously healthy neurons were. He observed a significant loss of neurons, as well as “a peculiar substance.” The tangles were indeed the tau proteins previously mentioned and the “peculiar substance” was beta-amyloid that formed the core of the plaques.[2]

“Alzheimer’s disease”

It was not until 1910 that the first use of the term “Alzheimer’s disease” was by Dr. Emil Kraepelin to categorize the disorder under “presenile dementia” as opposed to “senile dementia” that occurred later in old age.[3]  Later, “Alzheimer’s disease” was also used to describe “senile dementia,” as well. [4]

Advancements in science and technology eventually allowed researchers to have better understandings of the neurophysiological pathways through which the disease works. But this does not mean the incidence of the disease has reduced. In fact, researchers are tirelessly working towards finding a cure, and there is still work to be done.

Incidence of Alzheimer’s disease over time

Understanding how much and how often a disease has occurred over time is a challenging task, and medical researchers at the intersection of biostatistics and population studies have set out to do this job. A recent paper in the Journal of the American Geriatrics Society discussed how the incidence of dementia (not specific to Alzheimer’s) declined over the past four decades, but the incidence for Alzheimer’s specifically did not decrease.[5]

This trend will look different depending on how large your population size is and at what geographical extent. For example, while the previous study showed that Alzheimer’s disease incidence did not decrease over time, they were also relying on a dataset looking at countries around the world. Other studies that focus exclusively on the U.S. have found that incidence rates have decreased but only from the years 2007 to 2014.[6] That being said, population scientists, statisticians, and medical specialists are working to understand the distribution of Alzheimer’s across the world, what its causes are, and how to cure it. As our population is expected to increase from 7.7 billion to 9.7 billion by 2050, there will be an increase in demand for more healthcare services and likely more incidences of age-related illnesses.

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[1] Natalie S. Ryan, Martin N. Rossor, Nick C. Fox, Alzheimer’s disease in the 100 years since Alzheimer’s death, Brain, Volume 138, Issue 12, December 2015, Pages 3816–3821, https://doi.org/10.1093/brain/awv316
[2] Ibid.
[3] Bright Focus: “The History of Alzheimer’s Disease”
[4] Yang HD, Kim DH, Lee SB, Young LD. History of Alzheimer’s Disease. Dement Neurocogn Disord. 2016;15(4):115-121. doi:10.12779/dnd.2016.15.4.115
[5] Gao S, Burney HN, Callahan CM, Purnell CE, Hendrie HC. Incidence of Dementia and Alzheimer Disease Over Time: A Meta-Analysis. J Am Geriatr Soc. 2019 Jul;67(7):1361-1369. doi: 10.1111/jgs.16027. Epub 2019 Jun 20. PMID: 31220336; PMCID: PMC6612587.
[6] Kirson, N. Y., Meadows, E. S., Desai, U., Smith, B. P., Cheung, H. C., Zuckerman, P., & Matthews, B. R. (2020). Temporal and Geographic Variation in the Incidence of Alzheimer’s Disease Diagnosis in the US between 2007 and 2014. Journal of the American Geriatrics Society68(2), 346-353.

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