real life

The sad story of the first woman ever diagnosed with Alzheimer's disease.

 

Auguste Deter was just 51 when her husband, Karl, brought her to the City Hospital for the Mentally Ill and Epileptics in Frankfurt, Germany.

Her behaviour, he said, was making it almost impossible for him to work. She was confused and disoriented, had problems with language and writing, and would sometimes wake in the middle of the night and scream.

At the hospital, she met Dr Aloysius Alzheimer, who was a specialist in psychiatry and neuroscience. He initially diagnosed her with presenile dementia, but would later recognise in her the cardinal signs of what came to be known as Alzheimer’s disease.

It was 1901 when Auguste presented to hospital, but her patient file still exists, and includes transcripts of her conversations with Dr Alzheimer.

“She sits on the bed with a helpless expression,” he wrote of his first observations of her.

When Alzheimer asked his patient for her name, she replied ‘Auguste’. But when he asked for her husband’s name, she repeated her own. ‘Your husband?’ Alzheimer tried to clarify. “Ah, my husband,” Auguste said.

The questions that followed are similar to the interview used today to screen for Alzheimer’s disease. Auguste’s responses were as follows:

“How old are you?”

“Fifty-one.”

“Where do you live?”

“Oh, you have been to our place.”

“Are you married?”

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“Oh, I am so confused.”

“Where are you right now?”

“Here and everywhere, here and now, you must not think badly of me.”

“Where are you at the moment?”

“We will live there.”

“Where is your bed?”

“Where should it be?”

“In between she always speaks about twins,” Alzheimer noted. “Asked to write Auguste D., she tries to write Mrs and forgets the rest.”

Aloysius Alzheimer.
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Tragically, when she couldn't answer a question, or became confused, Auguste would repeat the words: "I have lost myself."

Over the next five years, Auguste's condition deteriorated to the point where she lost almost all her cognitive ability. At night, her condition seemed to get worse.

She was only 55 when in April, 1906, she passed away.

While Dr Alzheimer had moved to a different hospital, he requested Auguste's medical files upon hearing of her death. He was also able to gain her family's permission to perform an autopsy on her brain - which allowed for the observations that led to the discovery of Alzheimer's disease.

Alzheimer observed that the cerebral cortex was thinner than that of a healthy individual, and that plaques and tangles had formed.

These would go on to be the hallmark physiological signs of Alzheimer's disease - a progressive condition that destroys memory and other mental functions.

Over a century later, the cause of the disease is still unclear, although there appears to be a genetic component. There is still no cure for the disease, and it is terminal.

But for those touched by Alzheimer's, Auguste Deter's words of frustration, translated from German, epitomise the tragedy of the disease:

"I have lost myself."