Dementia and major neurocognitive disorders: some lessons learned one century after the first Alois Alzheimer’s clinical notes

Over 100 years ago, Alois Alzheimer presented the clinical signs and symptoms of what has been later called “Alzheimer Dementia” in a young woman whose name was Augustine Deter [1,2,3]. Alois Alzheimer described Augustine’s clinical history until her early death in 1906, and he focused his attention on a variety of impairments in functional domains in different phases of the disorder (first memory impairments, then delusions of husband’s adultery and sleeping disorders, then impairments in other cognitive domains and on consciousness). Alois Alzheimer studied her brain and described some peculiar clinical and pathological findings [1,2,3]. The word “dementia” was used for the first time by Pinel in 1797 [1,2], but there have been clinical notes on this disorder since ancient times. Some years later, the Alois Alzheimer’s clinical description of Augustine and after the endorsement of Kraepelin, who used for the first time the terminology “Alzheimer disease” in his 8th edition of Handbook of Psychiatry, dementia received a great attention from clinicians and from researchers. “Alzheimer Dementia” is now the most frequent and also the most known dementia all over the world [1,2,3]. Recently, international diagnostic criteria proposed to modify the name “dementia” with the string “major neurocognitive disorder” (MNCD) [4] aiming to reduce the negative stigma associated with the previous name and with his original meaning from the Latin word “demens” (“without mind”) [1]. Since the study of Alzheimer, MNCD gained a great attention in clinical and research field, and nowadays it is considered a major public health priority, due to its prevalence and incidence all over the world: over 6% in people older than 65 years, with an increasing of prevalence each five years of age and with an even higher prevalence in developing countries [5]. In this editorial, we aim to highlight some lessons learned in this field and to discuss some open questions since the first description of Alzheimer.