Abstract
Following previous observations a statistically significant association between various types of spirochetes and Alzheimer’s disease (AD) fulfilled Hill’s criteria in favor of a causal relationship. If spirochetal infections can indeed cause AD, the pathological and biological hallmarks of AD should also occur in syphilitic dementia. To answer this question, observations and illustrations on the detection of spirochetes in the atrophic form of general paresis, which is known to be associated with slowly progressive dementia, were reviewed and compared with the characteristic pathology of AD. Historic observations and illustrations published in the first half of the 20th Century indeed confirm that the pathological hallmarks, which define AD, are also present in syphilitic dementia. Cortical spirochetal colonies are made up by innumerable tightly spiraled Treponema pallidum spirochetes, which are morphologically indistinguishable from senile plaques, using conventional light microscopy. Local brain amyloidosis also occurs in general paresis and, as in AD, corresponds to amyloid beta. These historic observations enable us to conclude that chronic spirochetal infections can cause dementia and reproduce the defining hallmarks of AD. They represent further evidence in support a causal relationship between various spirochetal infections and AD. They also indicate that local invasion of the brain by these helically shaped bacteria reproduce the filamentous pathology characteristic of AD. Chronic infection by spirochetes, and co-infection with other bacteria and viruses should be included in our current view on the etiology of AD. Prompt action is needed as AD might be prevented.
Highlights
Alzheimer’s disease (AD) is the most frequent cause of dementia
It was anticipated that if AD is caused by spirochetes, the clinical and pathological hallmarks of AD should occur in syphilitic dementia, caused by T. pallidum
It is established that T. pallidum can cause slowly progressive dementia in the atrophic form of general paresis
Summary
Alzheimer’s disease (AD) is the most frequent cause of dementia. All efforts made in AD research during the last four decades provided important insights into the pathogenesis of AD but the cause of the disease is still unclear and the treatment unresolved.The clinical manifestations of AD begin with subtle short-term memory deficit and anxiodepressive symptoms followed by orientation and language difficulties. Alzheimer’s disease (AD) is the most frequent cause of dementia. All efforts made in AD research during the last four decades provided important insights into the pathogenesis of AD but the cause of the disease is still unclear and the treatment unresolved. The clinical manifestations of AD begin with subtle short-term memory deficit and anxiodepressive symptoms followed by orientation and language difficulties. The intellectual functions progressively disappear and the patients become entirely dependent. They may survive in this devastating state for more than a decade. Death generally occurs from secondary infection, frequently from pneumonia or urinary infection. The duration of the disease from the appearance of the first symptoms and the manifestation of dementia varies between 5 and 20 years
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