Clinical

Who is Auguste D?

Answer: Auguste Deter was an important case study in neuroscience. She was one of Dr. Alois Alzheimer's patients who had dementia, memory loss, and temporary vegetative states.

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Johanna Auguste Caroline Hochmann was born in 1850 in Germany. By the time she was 50, she started developing a variety of psychiatric conditions. She had experienced symptoms of dementia, such as difficulty with cognitive processes and changes in motivation. Shs had difficulty sleeping, and would often sleepwalk or scream in the middle of the night.. She had severe difficulties with memories, particularly declarative memory such as autobiographical memories. Her husband, Carl Deter, was unable to care for her, so she moved to Irrenschloss, an institution for the mentally ill based in Frankfurt, Germany. 

There, Auguste Deter became a patient of Dr. Alois Alzheimer. Deter's condition piqued Dr. Alzheimer's interest, and he initially diagnosed her with presenile dementia. She would say "Auguste" when asked what her name was, but when asked what her husband's name was, she would say "Auguste" again. She was able to identify and name a variety of common household items, but she would often name completely wrong or inappropriate words in response to questions. 

She also demonstrated profound memory related issues. Within minutes of being shown a variety of objects, she had a difficult time recalling which ones she had already seen and which items were novel. Her deficits became especially worse in the evenings, and her sleep was often disrupted.

For the following five years, Deter's condition worsened. She essentially lost all cognitive and reasoning capacity. 

Auguste Deter died on April 8, 1906, at the age of 55.

When Deter had died, Dr. Alzheimer contacted the hospital for access to her medical records. Upon analysis, Alzheimer was surprised to observe robust abnormalities of her cortex, which had become significantly smaller compared to similar aged people. This was remarkable because of her relative age, prompting an interest in the relationship between cortical size and cognitive ability. 

By today's neurological standards, Deter's condition would be early-onset Alzheimer's disease, a highly-aggressive form of the disease that is only found in about one-tenth of cases of Alzheimer's disease.