EVOLUTION IN THE CONCEPTUALIZATION OF DEMENTIA AND ALZHEIMERS-DISEASE- GRECO-ROMAN PERIOD TO THE 1960S

Most histories of senile dementia commence with Alois Alzheimer's desc ription in 1906 of the first case of Alzheimer's disease, yet the hist ory of senile dementia before 1906 is quite rich, dating back to the a ncient Greek and Roman philosophers and physicians. Over the 2500 year s since ancient times, the concept of senile dementia has evolved from a rather vague notion that mental decline occurred inevitably in old age, to become defined today by a distinct set of clinical and patholo gical features with the potential for treatment and prevention within grasp. Throughout history, many elderly individuals with unpredictable behavior were sequestered in institutions, and the line between menta l disorders and senile dementia was hazy at best. The identification o f Alzheimer's disease at the onset of the 20th century was a turning p oint for the understanding of senile dementia, and the concepts and hi stological findings presented by the early researchers of Alzheimer's disease remain relevant still today. Indeed, these early findings are proving to be a continuing source of insight, as many of the issues de bated at the turn of the century remain unresolved still today. This p aper thus traces the history of the evolution of our current conceptua lization of Alzheimer's disease from the amorphous Greco-Roman concept of age-associated dementia. (C) 1998 Elsevier Science Inc.