Auguste Deter (; 16 May 1850 – 8 April 1906) was a German woman notable for being the first person to be diagnosed with Alzheimer's disease.
Life
Auguste was born in Kassel, Hesse-Kassel on May 16, 1850. Born into a working-class family, Auguste had three siblings and was a daughter of Johannes Hohmann.
Auguste's father died when she was young. Even though Auguste's family was impoverished, she was well-educated. She attended school in Cassell, and it is speculated that she may have been a student of Dr. Alois Alzheimer's grandfather, Johann. He was a schoolmaster in Cassell during the time Auguste attended school. Further education was not possible for Auguste due to social norms and her family's financial situation.
Auguste started work as a full-time seamstress assistant at the age of 14. She continued this career until she married Carl August Wilhelm Deter on 1 May 1873, at the age of 23.
In 1888, Carl began work as a railway clerk. After marrying Carl, Auguste moved to Frankfurt, Germany, where she was a full-time housewife. Carl described their marriage as "happy and harmonious". The couple had one daughter named Thekla.
Auguste became ill in the spring of 1901 at the age of 50. She was admitted to a psychiatric hospital later that year in November, where she lived for the rest of her life.
Auguste and Carl were married for 33 years until her death on 8 April 1906 at the age of 55, just five weeks shy of her 56th birthday.
Onset of disease
During the late 1890s, Auguste exhibited a rapid escalation in memory loss and started showing symptoms of dementia, such as loss of memory, delusions, and even temporary vegetative states. In March 1901, Auguste's behavior started to become out of control. She began to accuse Carl of being adulterous and soon became jealous. Auguste started to become inattentive with housework, purposely hid objects and lost her capacity to cook. She also developed insomnia, which caused her to drag sheets outside the house and scream for hours in the middle of the night. She became paranoid over neighbors and strangers as she believed someone was out to kill her.
As a railway worker, Carl was unable to provide adequate care for his wife and was given recommendations by a local doctor to admit her into a mental hospital. She later was admitted to a mental institution, the (Irrenschloss) in Frankfurt on 25 November 1901. There, she was examined by Dr. Alois Alzheimer.
Carl visited Auguste whenever possible, though he struggled to make payments for her care and stay. It would have been more financially efficient to spend the time at work. Having difficulty keeping up with the payments, Carl continued insisting on getting her into a more affordable facility. Such a transfer would remove Auguste from Alzheimer's care, but Carl continued to persist in transferring Auguste. When asking Alzheimer for an arrangement of hospital transfers, Alzheimer discouraged him from such a decision; instead, he offered him an agreement for her to continue to receive care without cost in exchange for her medical records and brain after death, to which Carl gave a signed consent.
Treatment
Dr. Alzheimer asked her many questions, then later asked again to see if she would remember. He asked her to write her name. She tried to, but would forget the rest and repeat: "I have lost myself." (German: "Ich habe mich verloren.") He later put her in an isolation room for a while. When he released her, she would run out screaming, "I will not be cut. I do not cut myself."
After many years, she became completely addled with dementia, muttering to herself. She died on 8 April 1906. More than a century later, her case was re-examined with modern medical technologies, where a genetic cause was found for her disease by scientists from Gießen and Sydney. The results were published in the journal of The Lancet Neurology. According to this paper, a mutation in the PSEN1 gene was found, which alters the gamma-secretase function and is a known cause of early-onset Alzheimer's disease. However, the results could not be replicated in a more recent paper published in 2014 where "Auguste D's DNA revealed no indication of a nonsynonymous hetero- or homozygous mutation in the exons of APP, PSEN1, and PSEN2 genes comprising the already known familial AD mutations." It is suggested that Auguste's daughter Thekla would have had a 50% chance of inheriting the PSEN1 gene and developing Alzheimer's, although there is no recorded information of her developing such an illness.