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November 10, 1989

Alzheimer's Disease in the Community

Author Affiliations

University of Washington Medical Center Seattle

University of Washington Medical Center Seattle

JAMA. 1989;262(18):2591-2592. doi:10.1001/jama.1989.03430180133043

In 1907, when Alois Alzheimer published his original description of the disease now known as "Alzheimer's disease," he described a 51-year-old woman whose "entire behavior bore the stamp of utter perplexity."1 The generalized dementia progressed for 4 1/2 years, and she was eventually bedridden and completely unable to care for herself. Pathological study demonstrated the characteristic senile plaques and neurofibrillary tangles.

The traditional distinction between early-onset and lateonset Alzheimer's disease can be traced, in my judgment, to the epidemiologic observation that Alzheimer's disease in persons younger than 60 years is rare whereas it is one the most common conditions seen in older patients.2 Just how common is a matter of some contention, but the dramatic increase seen in individuals more than 80 years of age has been a consistent observation since the epidemiology of "clinically diagnosed" (ie, antemortem) Alzheimer's disease was first studied in England and Sweden in