One of the first cases of dementia was described by professor Alois Alzheimer, Germany, in 1906. He first examined Auguste D, a 51-year old female patient, at Frankfurt hospital in 1901 and continued to follow her case after he left for the Royal Psychiatric Clinic in Munich, up until her death on April 8th, 1906. Even after her death he went on to study the neuropathological features of her illness. Shortly after her death he presented her case at the 37th Conference of German Psychiatrist in Tubingen on Nevember 4th, 1906 in which he described her symptoms as progressive cognitive impairment, focal symptoms, hallucinations, delusions, psychosocial incompetence with the following neurobiological changes found at autopsy: plaques, neurofibrillary tangles and artheriosclerotic changes. Alzheimer's disease (AD) effects about 2-3% of persons at age 65 years with a doubling of incidence for every five years of age afterwards. AD is the most common cause of dementia in western countries. Approximately 10 percent of all persons over 70 years have significant memory loss and more than half is the result of AD, which translates to about 3-4 million persons in the United States. This results in a total health care cost of more than 50 billion dollars per year in the United States and the estimated annual cost of caring for a single AD patient in an advanced stage of the disease is USDollars 47,000. Clinicaly AD most often presents with a subtle onset of memory loss followed by a slowly progressive dementia that has a course of several years. Adults with trisomy 21 (Down syndrome, DS) develop the typical neuropathological hallmarks of AD if they survive beyond 40 years. Many also develop a progressive dementia superimposed on the baseline intellectual disability. This handbook with 22 contributors gives you a broad interdiscplinary approach to the diagnosis, treatment and comorbidities of dementia, which we would like to recommend to professionals working with this disability population.
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