Alois Alzheimer's case of Auguste D.

In March 1901 the husband of a 50-year-old woman in Frankfurt, Auguste D., noticed paranoid ideas in his wife, followed quickly by disturbed sleep, failing memory, aggression, crying and growing confusion. He took her to the Frankfurt psychiatric hospital, where Alois Alzheimer was senior assistant, and Alzheimer recorded her illness in detail from her admission in November 1901.

Alzheimer, born in Marktbreit in Bavaria in 1864, had trained in anatomy and microscopy and later joined Emil Kraepelin in Munich as a lecturer. Auguste D. remained in the Frankfurt hospital until her death on 8 April 1906, and after the autopsy Alzheimer examined her brain under the microscope, comparing what he found with more than four years of clinical notes.

On 3 November 1906, at the 37th Meeting of South-West German Psychiatrists in Tübingen, he reported on a peculiar severe disease process of the cerebral cortex, describing distinctive plaques and neurofibrillary tangles. The audience showed little interest. The chairman, Alfred Hoche, invited no discussion, the proceedings printed only a short abstract, and the local press gave the talk two lines.

Kraepelin saw its importance and included Alzheimer's disease in the eighth edition of his textbook Psychiatrie in 1910. Alzheimer's Italian coworker Gaetano Perusini published Auguste D.'s case with three similar ones in 1909. In 1911 Alzheimer described a man, Josef F., whose brain showed plaques without tangles, a form later judged to be another stage of the same process. Alzheimer died in 1915, aged 51, soon after taking the chair of psychiatry in Breslau.

In 1995 K. Maurer found Auguste D.'s clinical file in the Frankfurt archives, and her slides were later located in Munich and reexamined with modern methods. The US National Institute on Aging describes the plaques, now known to be amyloid, and the tau tangles as still among the main features of Alzheimer's disease, which it calls the most common cause of dementia among older adults.