HISTORY OF DEMENTIA- WHEN DID IT ALL START

HISTORY OF DEMENTIA

Dementia history dates back to 2000 BC, when Egyptian psychiatrists first documented the concept. However, it was not until 1797 that the phenomenon was given a name. Derived from Latin, the word dementia literally means ‘out of one’s mind.’ The term was first coined by a French psychiatrist, Philippe Pinel.

During the 18th century, dementia was a term used for people with intellectual deficit, acquired at any age. By the end of the 19th century, the term was restricted for people with loss of cognitive ability. It was during this century when the term ‘senile dementia’ was also introduced by Doctor James Cowles Prichard in his book, A Treatise on Insanity. The word senile, which means old, is attached to any type of insanity that occurred in old people. And since one of the most prominent symptoms of dementia is memory loss, it was mostly associated with old age.

Dementia, basically, is a broader term used for disorders that affect the brain. Back in time, syphilis was considered as the common cause of dementia. It was only in 1906 that Alzheimer’s was identified as the major culprit.

In 1901, a 51-year-old woman August D’s husband admitted her to the state asylum in Frankfurt as she was suffering from paranoia, aggressive behaviour, memory loss, language problems and hallucinations. Her case was followed by Dr. Alois Alzheimer. In 1903, Alois moved to Munich to work with Emil Kraepelin—a well-known psychiatrist of that era.

In 1906, when August D died, her brain was sent to Dr. Alois for examination. While presenting the post mortem report, Dr. Alois mentioned August D’s both cognitive and non-cognitive deficits, highlighting plaques, arteriosclerotic changes and tangles in her brain. He wrote: “The autopsy reveals, according to Alzheimer’s description, changes that represent the most serious form of senile dementia… the Drusen were numerous and almost one-third of the cortical cells had died off. In their place instead we found peculiar deeply stained fibrillary bundles that were closely packed to one another, and seemed to be remnants of degenerated cell bodies.”

The plaques and tangles identified by Dr. Alois are the main causes of Alzheimer’s, including the loss of connection between nerve cells. The plaques and tangles are formed due to abnormal deposits of protein. Usually, no symptoms appear during the initial stages of the disease. In fact, it is believed that brain damage starts a decade before any cognitive problems surface. The damage starts in the hippocampus, which is responsible for memory. Once neurons start dying, they shrink and by the final stage considerable damage is done, which makes the disease irreversible.

A lot has been done since Dr. Alois’s discovery. In 1931, Max Knoll and Ernst Ruska invented the electron microscope. With magnification up to 1 million times, the microscope helped scientists study brain cells with greater depth. In 1983, an entire month was dedicated to Alzheimer’s Disease, to raise more awareness about the disease. In 1984, National Institute of Aging started supporting Alzheimer’s disease centres and established nationwide network for research. By 1993, scientists had come up with the first drug, called Cognex, to treat dementia symptoms and memory loss.

Other than Alzheimer’s, dementia is also caused by strokes, which is known as vascular dementia. Head trauma, Lewy body disease, Creutzfeldt-Jakob disease, and Huntington’s disease are also responsible for causing the ailment.

Dementia is broadly divided into two categories: early onset and late onset. People who contract the disease before the age of 65 are known to have early onset dementia. Dementia in younger people is likely to cause co-ordination and movement problems. Also, there are high chances that young on-set dementia is hereditary.

Life expectancy of people suffering from the ailment is only 4 to 8 years. Today, more than 47.5 million individuals worldwide have dementia worldwide. However, only 1 in 4 people have been diagnosed. Alzheimer’s is the 6th leading cause of death in the United States. In fact, since 2000, deaths from heart disease have dropped by 14% and deaths from Alzheimer’s have soared by 89%. It is estimated that in 2017 the disease will cost the nation around $259 billion and by 2050 this figure could rise to $1.1 trillion.

A lot is being done globally to fight this ailment. In 2011, President Barack Obama signed the National Alzheimer’s Project Act (NAPA) and in 2012, the US department of health and human services revealed a National plan to address Alzheimer’s disease. The goal of this plan is to prevent and effectively treat Alzheimer’s by 2025. Under this plan, a lot of budget was allocated to research. In 2012, National Institute of Health committed $50 million. The funding made two clinical trials possible: a $7.9 million trial that test an insulin nasal spray in people with early symptoms and a $16 million prevention trial. In 2013, NIA gave another $45 million for researching drugs that prevent Alzheimer’s. In October 2012, Banner Alzheimer’s Institute launched Alzheimer’s Prevention Registry, an online shared resource, which people, across the United States, can use to learn more about the disease and participate in research studies.

Despite all the efforts, the disease is still prevalent and in fact the number of occurrences is expected to rise. This is probably because it cannot be prevented completely, but that doesn’t mean all the efforts to increase awareness should be stopped as certain steps such as right diet and exercise can definitely lower the risk.