This book is an overview of Alzheimer disease (AD). The author, David Shenk, notes that AD was once thought to be unusual, but, because of improved sanitation, nutrition, and treatment of infectious illnesses, the population of the United States is aging, and between four to five million people now have the disease.
Shenk begins by describing the first reported case. Auguste D. was hospitalized in Frankfurt, Germany, in 1901 at the age of 51 years because of problems with her memory and behavior. Dr Alois Alzheimer, clinician and neuropathologist, evaluated her. Over the next 4 years Ms D. deteriorated badly and became incontinent, incoherent, and immobile. Alzheimer was puzzled by her illness and so examined her brain at her death. He was able to take advantage of the recent work of Franz Niss, who had improved tissue stains, and Ernst Leitz and Carl Zeiss, who had devised relatively distortion-free microscopes. Alzheimer described the astonishing finding of tangles and plaques that had taken over Ms D.'s brain. These findings were ignored until they were referenced by Emil Kraepelin, who was looking for support in his dispute with Sigmund Freud over whether or not there was a biological component to mental illnesses. This form of dementia is now eponymously associated with Alzheimer.