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On the Brain
February 18, 2019

Early Awareness of Alzheimer Disease: A Neurologist’s Personal Perspective

JAMA Neurol. 2019;76(3):249. doi:10.1001/jamaneurol.2018.4910

I am a 67-year-old retired neurologist with early-stage Alzheimer disease (AD). Before completing my neurology training, I was a scientist studying the neuroendocrinology of stress. I then spent nearly 25 years practicing and teaching general neurology.

My first symptom of AD occurred at age 55 years when I discovered that I couldn’t detect subtle odors, like the scent of a flower. Within a year I began to have frequent stereotypical phantosmias unprovoked by external odors several times a month. At first these consisted of the pleasant scent of baking bread combined with perfume. They would last from a few minutes up to an hour. Over the next 5 or 6 years as I completely lost my ability to smell, the phantosmias gradually took on a more citrus like hue but were never unpleasant. They became less and less frequent, finally occurring 2 or 3 times in a year and stopping altogether about a year ago.

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