Surname:

Alzheimer

First name:

Aloysius

Place of birth:

Marktbreit (DEU)

* 14.06.1864

† 19.12.1915

German psychiatrist and neuropathologist, the first one to describe Alzheimer’s disease.

Aloysius “Alois” Alzheimer (1864–1915) was born on 14 June 1864 in Marktbreit, Bavaria, as the son of the notary public Eduard Alzheimer and his second wife, Theresia. The father had a son from his previous marriage; Alois Alzheimer was the eldest of six more children (Toodayan 2016; Blatt 2012: 346 ff.; Hippius 2003: 102). After completing school education in Aschaffenburg in 1883, he studied medicine in Berlin, Würzburg, Freiburg, and Tübingen. Alzheimer graduated in 1888 and, in the same year, earned his doctorate with a thesis titled Über die Ohrenschmalzdrüsen [About the Ceruminous Glands]. He then spent a semester working at the Würzburg Institute of Anatomy under Albert Kölliker (1817–1905) and as a junior physician under Emil Sioli (1852–1922) at the municipal asylum in Frankfurt. He was later promoted to senior physician at the same institution (Blatt 2012: 22 ff.). Sioli had a strong influence on Alzheimer; together, they developed new forms of treatment, seeking to abandon coercive measures (e.g., straitjackets, isolation rooms) in favor of occupational activities. The patients were also given the opportunity for outdoor walks (Blatt 2012: 67 ff.; Hippius 2003: 102 f.).

In 1894, Alzheimer married Cecilie Geisenheimer (née Wallerstein). Their daughter Gertrud was born in 1895, followed by Hans in 1896, and Maria in 1900. In 1901, Cecilie Alzheimer fell ill and died shortly thereafter. To cope with his grief, Alzheimer devoted himself even more to his work (Hippius 2003: 103; Maurer 2009).

Alzheimer in Heidelberg, Munich, and Breslau

In 1902, Alzheimer transferred to the Psychiatric University Hospital in Heidelberg to work with Emil Kraepelin (1856–1926). He conducted research on progressive paralysis, brain arteriosclerosis, alcoholism, and epilepsy, and also worked in forensics (Maurer 1997: 1546). He followed Kraepelin to Munich in 1903 and obtained the formal qualification for a professorship (“Habilitation”) in 1904 with his postdoctoral thesis Histologische Studien zur Differentialdiagnose der Progressiven Paralyse [Histological Studies on the Differential Diagnosis of Progressive Paralysis]. In Munich, then the center of neuropathology, Alzheimer established his own brain anatomy lab. There he also examined specimens that he had sent from Frankfurt (Thiel 2006: 16), which ultimately led to the discovery of “Alzheimer’s disease”.

In 1912, he transferred to Breslau to succeed Karl Bonhoeffer (1868–1948) both as professor at the local university and as director of the psychiatric hospital. In the following year, he contracted a serious infection that attacked his heart. He recovered only with difficulty, and in 1915, his condition worsened. Alois Alzheimer died in Breslau on 19 December 1915, surrounded by his family (Hippius 2003: 107).

The case of Auguste D.

Alzheimer examined his patient Auguste Deter (1850–1906) for the first time in 1901. She had been leading a normal life, was married, and had a daughter. Her husband took her to the asylum in Frankfurt, reporting that her personality had changed significantly over the past years: she had begun hiding things, was no longer able to perform even simple household tasks, and felt persecuted. When interviewed, she seemed to be severely mentally confused, with no orientation in time and place. She was barely able to remember her own past, often gave answers without reference to the questions asked (Alzheimer 1907: 146 ff.), and her mood alternated between fear, distrust, rejection, and weepiness. Alzheimer had some experience with confused but usually much older patients – while Auguste D. was no older than 51 at the time of her hospitalization (Thiel 2006: 16 f.). She died in 1906 from a sepsis caused by pressure ulcer. Alzheimer had her medical record and brain taken to his Munich lab where he found a cortical atrophy with amyloid deposits in the cerebral cortex (Alzheimer 1907: 146 ff.). He reported on these striking neuronal changes in his patient at a symposium in Tübingen in November 1906 (Maurer 1997: 1546; Alzheimer 1907: 146 ff.)´and published his findings in an article titled Über eine eigenartige Erkrankung der Hirnrinde [About a Peculiar Disease of the Cerebral Cortex] in the journal Allgemeine Zeitschrift für Psychiatrie in 1907. Some years later, Kraepelin (1910: IX, 624 ff.) referred to this form of presenile dementia as “Alzheimer’s disease”.

Alzheimer was the first to describe changes in the brain leading to a progressive loss of memory and personality in patients with Alzheimer’s type of dementia by using microscopic findings (cf. Cipriani, Danti & Carlesi 2016). This achievement was based on precise neuroanatomical descriptions: “This observation will have to suggest to us that we should not let ourselves satisfied with trying to include – with mobilization of many an effort – any clinically unclear illness case into one of the diagnostic entities known to us. There are without any doubt many more psychic illnesses than listed in our textbooks. In some of these instances, a later histological examination will subsequently reveal peculiarities of the specific case. Then, we will gradually arrive at a stage when we will be able to separate out individual disease from the large illness categories of our textbooks; to delineate them clinically more accurately” (Alzheimer 1907: 148, quoted in Strassnig 2005: 33).

It was not until 1995 that Auguste Deter’s medical file was recovered by Konrad Maurer in the archives of the psychiatric clinic in Frankfurt (Maurer & Maurer 2009; Hippius 2003: 106; Graeber 1999).

Literature

Alzheimer, A. (1904): Histologische Studien zur Differentialdiagnose der Progressiven Paralyse. Jena: G. Fischer.

Alzheimer, A. (1907): Über eine eigenartige Erkrankung der Hirnrinde. In: Allgemeine Zeitschrift für Psychiatrie 64 (1), pp. 146–148.

Alzheimer, A. (1911): Über eigenartige Krankheitsfälle des späteren Alters. In: Zeitschrift für die gesamte Neurologie und Psychiatrie 4 (1), pp. 356–385.

Alzheimer, A. (1913): 25 Jahre Psychiatrie. In: European Archives of Psychiatry and Clinical Neuroscience 52 (3), pp. 853–866.

Alzheimer, A. (1915): Der Krieg und die Nerven. Berlin: Preuß & Jünger.

Bick, K. L., L. Amaducci (1987, eds.): The Early Story of Alzheimer’s Disease. Translation of the Historical Papers by Alois Alzheimer, Oskar Fischer, Francesco Bonfiglio, Emil Kraepelin, Gaetano Perusini. Padua: Liviana.

Blatt, L. (2012): Über Alois Alzheimers Werk und Leben (1864–1915). Doctoral Thesis. Johann Wolfgang-Goethe-University Frankfurt, Department of Philosophy and History. Frankfurt on the Main.

Cipriani, G., S. Danti, C. Carlesi (2016): Three Men in a (Same) Boat: Alzheimer, Pick, Levy. Historical Notes. In: European Geriatric Medicine 7 (6), pp. 526–530.

Goedert, M., B. Ghetti (2007): Alois Alzheimer: His Life and Times. In: Brain Pathology 17 (1), pp. 57–62.

Graeber, M. B. (1999): No Man Alone. The Rediscovery of Alois Alzheimer’s Original Cases. In: Brain Pathology 9 (2), pp. 237–240.

Hippius, H., G. Neundörfer (2003): The Discovery of Alzheimer’s Disease. In: Dialogues in Clinical Neuroscience 5 (1), pp. 101–108.

Jürgs, M. (2006): Alzheimer. Spurensuche im Niemandsland. Munich: Bertelsmann.

Kraepelin, E. (1910): Psychiatrie. Ein Lehrbuch für Studierende und Ärzte. 8th edition, Vol. 2, Klinische Psychiatrie, Part 1. Leipzig: Barth.

Kreuter, A. (1996): Deutschsprachige Neurologen und Psychiater. Ein biographisch-bibliographisches Lexikon von den Vorläufern bis zur Mitte des 20. Jahrhunderts. Vol. 1. Munich: Saur, pp. 31–34.

Maurer, K., S. Volk, H. Gerbaldo (1997): Auguste D. and Alzheimer’s Disease. In: The Lancet 349, pp. 1546–1549.

Maurer, K., U. Maurer (1998): Alzheimer. Das Leben eines Arztes und die Karriere einer Krankheit. Munich: Piper.

Maurer, K., U. Maurer (2009): Alois Alzheimer. 1864–1915. Leben und Werk in Wort und Bild. Marburg: Pre Press.

Maurer, K., U. Maurer (2009): Alzheimer und Kunst. Carolus Horn – Wie aus Wolken Spiegeleier werden. Frankfurt on the Main: Frankfurt Academic Press.

 Meyer, J. E. (1961): Alois Alzheimer. Stuttgart: Thieme.

Schachter, A. S. et al. (2000): Alzheimer’s Disease. In: Dialogues in Clinical Neuroscience 2 (2), pp. 

   91–100.

Strassnig, Martin T. (2005): A Peculiar Disease of the Cerebral Cortex. Alzheimer’s Original Case Revisited. In: Psychiatry 2 (9), pp. 30–33.

Thiel, van D. (2006, ed.): 20 Jahre Alzheimer Gesellschaft München e.V. – Festschrift. Munich: Müller.

Toodayan, N. (2016): Professor Alois Alzheimer (1864–1915): Lest We Forget. In: Journal of Clinical Neuroscience 31 (9), pp. 47–55.

Wichelhaus, B. (2002): Das Oeuvre von Carolus Horn aus künstlerischer und kunsttherapeutischer Perspektive – “ein Alzheimerpatient macht Karriere”. In: Zeitschrift für Musik-, Tanz- und Kunsttherapie 13 (3), pp. 123–128.

Zilka, N., M. Novak (2006): The Tangled Story of Alois Alzheimer. In: Bratislavske lekarske listy 107 (9/10), pp. 343–345.

Ansgar Fabri, Annette Baum

Photo: Bonio; Source: Wikimedia / License: CC BY-SA 3.0