No, the psychoanalyst Sigmund Freud did not have Alzheimer’s Disease. And, to the best of my knowledge, he knew of neither Alzheimer’s disease nor its founder, Alois Alzheimer. But according to at least one knowledgeable source1, Freud might have played an inadvertent role in Alzheimer’s being declared a disease. Alois Alzheimer was deeply conflicted about this issue. Clearly his patient was cognitively impaired. But was his patient suffering from a unique disease or was this just another manifestation of the many symptoms of dementia?
Alzheimer was offered a position in the laboratory of Emil Kraepelin. Emil Kraepelin was one of the most prominent psychiatrists of the era as was Sigmund Freud. However, the differed drastically in their approaches to psychiatry. Kraepelin was strongly of the opinion that psychiatry should be physically based just as the other medical specialties. However, at that time, Freud was all the rage with his psychological approach. Kraepelin wanted to move the emphasis in psychiatry back to a physical basis. Terming Alzheimer’s a disease, put it in the same category as tuberculosis and influenza. He was not claiming that mental diseases were necessarily infectious and transferable, but rather that they had a physical basis. As Alzheimer was an employee of Kraepelin, this might have played some role in it being declared a disease.
Some might wonder whether this is an important distinction. It is, as it affects the approaches taken. If it is a distinct disease, then it has a distinct diagnosis, and perhaps a distinct cure or treatment. If it is just another manifestation of dementia, then the question remains as to what is being treated. The best single predictor of whether a person will come down with Alzheimer’s is the person’s age. So Alzheimer’s is a product of aging, although it is not a necessary result of aging, as many age without suffering from the dementia known as Alzheimer’s. But the best predictor is not found in the genetics of an individual, although some people are more susceptible than others, but in age. Whether a person’s cognitive impairment can be diagnosed confidently must await an autopsy and the presence of amyloid plaque and neurofibrillary tangles. But autopsies have been performed on people who had amyloid plaque and neurofibrillary tangles, yet never showed any evidence of cognitive impairment while living. So what is Alzheimer’s? Fortunately we can take actions to reduce the risk of Alzheimer’s. Identifying these actions is one of the principal objectives of the Healthymemory Blog.
1Whitehouse, P.J., & George, D. (2008). The Myth of Alzheimer’s. New York: St. Martin’s Press.