Dieser Beitrag ist auch verfügbar auf:
Deutsch
An old man wanders through the house at night. He’s wearing five shirts on top of each other, his pockets are stuffed with dishes, towels and a toothbrush – and he wants to go to school. A woman suddenly shouts at her grown-up daughter, asks who she is and claims that she is stealing her things – only to cry like a little child shortly afterwards. Diagnosis in both cases: Alzheimer’s disease. Around 1.5 million people suffer from dementia in Germany alone. The German Alzheimer’s Society expects three million people to be affected by 2050 due to increasing life expectancy.
What happens in the brain?
The generic term dementia refers to all clinical pictures in which the person affected almost completely loses their mental functions such as thinking, remembering, orientation and linking thought content. The most common form of dementia is Alzheimer’s dementia. Two thirds of those affected suffer from it. Nerve cell by nerve cell slowly dies in the brain. brain years before the first symptoms appear.
The reason for the dying nerve cells is a faulty metabolic process in the body. Either excessive deposits of a protein are produced or the body does not properly break down the regularly occurring protein deposits. Like a poison, these then attack nerve cells, synapses and energy-providing mitochondria, which then die.
What triggers the faulty metabolic process?
Some doctors are still struggling to find the answer to this question. The causes of the very rare, early cases, which often occur within a family, are best known. Here, errors in the genetic material, so-called mutations, trigger the excessive production of protein proteins. The symptoms of hereditary Alzheimer’s disease usually appear before the age of 60.
Several factors play a role in non-hereditary Alzheimer’s dementia. The most important of these is age. Whereas only around one in a hundred 60-year-olds is affected, one in ten 80-year-olds suffers from Alzheimer’s, and one in three 90-year-olds. Genetic factors also play a role, but they do not cause the disease, they merely promote it. According to the German Alzheimer’s Society, those who have had little mental, social or physical exertion throughout their lives are also more susceptible to dementia.
The psychiatrist Alois Alzheimer first discovered brain changes in his patient with dementia, Auguste Deter, over 100 years ago. At the time, he still thought he was dealing with a very rare disease. In 1996, doctors Volk, Gerbaldo and Maurer found Auguste D.’s medical records in the archives of the psychiatric clinic in Frankfurt.
The “Auguste” case
Frankfurt in 1901: Alois Alzheimer works as an assistant doctor at the municipal sanatorium for the insane and epileptic. On November 25, a man brings his confused and disoriented wife to the asylum. Her name is Auguste Deter and she is 51 years old. The following dialog that Alzheimer had with his patient Auguste made medical history: “What is your name?” – “Auguste.” – “Family name?” – “Auguste.” – “What is your husband’s name?” – “I think … Auguste.” Physically, the woman appears to be in perfect health, and the doctors can also rule out psychological trauma. You are faced with a conundrum. Alzheimer recorded his observations on 31 pages.
Brain research was the trend
In 1904, Alois Alzheimer leaves Frankfurt to head the Brain Anatomy Laboratory at the Psychiatric Clinic in Munich. He regularly enquires about Auguste Deter’s state of health. When she died two years later on April 8, 1906, he had his former patient’s medical records and brain sent to him. Under the microscope, he discovers massive cell atrophy and unusual deposits. Six months later, at the 37th Assembly of Southwest German Lunatic Doctors, he reported on the peculiar clinical picture and a “peculiar severe disease process of the cerebral cortex”.
As brain research was in vogue at the time, colleagues did not really take his discovery seriously, treating it merely as a curiosity. At the turn of the century, many doctors examined brains under the microscope, used dyes to visualize structures and described conspicuous changes. However, Alzheimer was the first to establish a link between deposits and memory loss in a younger patient.
Don’t look away, take action
The responsibility for Alzheimer’s patients does not end with their relatives or the doctors treating them. Society must also be sensitized to the disease and thus register abnormalities. Whether it’s the elderly lady who wanders through the city center in winter without a jacket, the bank customer who withdraws large sums of money or the senior citizen who picks up bread rolls from the bakery three times a day.
It is important to act and not look away. Those affected usually do this themselves, because forgetting brings fear and shame. Alzheimer also recognized fear, mistrust, rejection and despair in his patient Auguste. In her conversations with him, she said: “I sort of lost myself.” Alzheimer spoke of the “disease of forgetting” – it was only named after him after his death. He died in 1915 at the age of just 51 – younger than his patient.
