[Alzheimer's disease followed in a single case]

Descriptions of Alzheimer's disease are usually based on the observation of populations of patients. Their advantage is the systematic analysis of signs and symptoms according to a logical approach enumerating the involvement of neurological, neuropsychological, affective and behavioral fields. Their disadvantage is to neglect the natural evolutive way and the subtle gearing of these diverse aspects of the disease. This paper aspires to bring a complement to the necessary systematic knowledge, by the description of a patient who has been followed regularly every 3 months for 4 and a half years. It describes the evolution as it is lived by the patient and his spouse, and as it is observed by the clinician. Three main facts are inferred. The first is the precocious involvement of two functions particularly affected later: language and the ability of identifying others. The second is with the evolution of the disease the identification, in the neuropsychological domain, of some tests which show no or little alteration, of some others altered from the outset, the majority deteriorating progressively. The third is the observation of a brisk and definitive worsening following a transient ischemic attack, demonstrating the vulnerability of these patients when the disease has reached an advanced stage.