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While the treatment of Alzheimer's disease has advanced over the past 100 years, the core principles of care have remained the same, according to a the authors of a Viewpoint in this week's issue of The Lancet. The publication coincides with the anniversary of the first presentation of the disease by psychiatrist and pathologist Alois Alzheimer in Tubingen, Germany, on November 3, 1906. Alzheimer's disease is a chronic neurodegenerative disorder currently affecting an estimated 25 million people worldwide. The disease is characterised by memory impairment, prominent psychiatric symptoms, and behavioural disturbances, which result in difficulties with activities of daily living. The cause of Alzheimer's disease is largely unknown and treatment is directed towards symptomatic improvement of memory and other cognitive functions, and control of behavioural disturbances. Alzheimer's description of his patient Auguste D, a woman who developed dementia in her 50s and died on April 8, 1906, is published in the Viewpoint along with commentaries by leading clinicians. They note that today the quality of Auguste D's treatment would depend on the skill of the clinical team attending her as it did 100 years ago. The use of non-pharmacological strategies to manage the neuropsychiatric symptoms of the disease would also be common today as it was then. However, few of the non-drug approaches used by Dr Alzheimer have survived the test of time. Today Auguste D might receive bright-light therapy, aromatherapy, or one or several behavioural treatments, state the authors. The authors conclude: "The availability of various drugs for the treatment of the symptoms of Alzheimer's disease is the main advance over the past 100 years. Although the practice of care may have changed, the core principles have remained the same." ### Contact: Professor Alistair Burns, Academic Department of Psychiatry, The University of Manchester, Education & Research Centre, Wythenshawe Hospital, MANCHESTER, M23 9LT, UK.
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Contact: Joe Santangelo Lancet
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