Abstract
In the late 1800s, in the Ukrainian town of Ekaterinoslav, Hannah, a woman only in her forties, began suffering from progressive memory loss and eventually became unable to care for herself. What seemed an isolated incident remained unexplained at her death in the 1890s. Years later, Hannah's grandson Charles, a physician, spurred by his painful observations that many members of his family were all suffering from the same disease, began charting the family's medical history over five generations. In 1985, when this pedigree-one of the most extensive of its kind-fortuitously fell into the caring hands of neurologist Dr. Dan Pollen, Hannah's family would find themselves immersed in one of the most enduring scientific searches of the century-the quest for the Alzheimer's disease genes. In Hannah's Heirs, Dr. Pollen himself tells the compelling story of Hannah's family and their monumental contributions to the fight against Alzheimer's. We are there in 1985 when Charles presents Pollen with three decades' worth of family medical records as well as data from studies that even Pollen and his associates did not then know existed. We see the selfless acts of Hannah's descendants in their struggle against Alzheimer's: great-grandson Jeff's conviction that after his death his brain be used for all possible research; great-granddaughter Lucy's decision to overcome her dread of flying in order to reach the research centre for testing; and Charles's continued research in the face of a disease that might strike him at any moment. Pollen sets this gripping story within the larger context of the efforts to solve the mysteries of Alzheimer's. He presents the foundations of modern genetic research, from Gregor Mendel's classic discovery of genes, to Alois Alzheimer's work on the brains of presenile dementia victims, to Watson and Crick's double helix model for the structure of DNA. He narrates the latter-twentieth century efforts of scientists to systematically narrow down the causes of Alzheimer's: Carlton Gajdusek's research excluding slow viruses as a cause of Alzheimer's; and the stunning success of Peter St. George- Hyslop's group in Toronto in September 1992 in decisively linking Alzheimer's in Hannah's family to chromosome 14. At the same time, Pollen offers a penetrating look at the ongoing conflicts involved in scientific research, revealing how intense competition for prestige and funding has driven some scientists to hoard precious cell lines. These practices have impeded efforts to discover both the causes and the treatment of Alzheimer's in the shortest possible time. As Hannah's great-grandson Ben has written, This is a story that had to be told. Aspirations were transcendent, but because it involved people it could not be told without tears. Written by a physician-scientist who has been a central figure in the study of familial Alzheimer's, Hannah's Heirs is an inspiring portrait of the efforts of a courageous family to confront and overcome a personal biological Holocaust, and an encouraging look at the advances in science that have created the basis for the eventual understanding and treatment of Alzheimer's disease. And for those who have seen the horrors of Alzheimer's, for all who fear the aging process that will take its toll on everyone, here is an inside look at one of the great medical detective stories of our time.
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