Dementia was extremely rare in ancient times, so why is it now so prevalent?

In our exploration of age-related dementia throughout history, a common belief is that this affliction is as old as humanity itself.

However, research led by the University of Southern California (USC) suggests a different history behind this disease.

This study delves into classical Greek and Roman medical texts, revealing that severe memory loss, now almost epidemic, was surprisingly rare around 2,000 to 2,500 years ago.

This finding strengthens the theory that Alzheimer’s and related dementias are largely products of modern lifestyles and environments.

Factors like sedentary behavior and air pollution are significant contributors.

Tracking dementia throughout history

Caleb Finch, the study’s first author and a University Professor at the USC Leonard Davis School of Gerontology, sheds light on the ancient Greeks’ understanding of memory issues.

“The ancient Greeks had very, very few — but we found them — mentions of something that would be like mild cognitive impairment,” said Finch.

They acknowledged mild cognitive impairments, akin to what we identify today, but nothing on the scale of Alzheimer’s, which involves substantial loss of memory, speech, and reasoning.

The study’s journey through ancient medical literature, including works by Hippocrates and his disciples, reveals intriguing insights.

These texts extensively catalog ailments common in older people, such as deafness and dizziness, yet surprisingly omit significant memory loss. However, as we shift to ancient Rome, the narrative changes slightly.

Notable figures like Galen and Pliny the Elder begin to document instances of memory decline in older populations.

For example, Galen observed learning difficulties in some 80-year-olds, while Pliny the Elder recounted a senator who forgot his own name. Cicero, too, noted a kind of “elder silliness,” though he didn’t associate it with all older men.

“When we got to the Romans, and we uncovered at least four statements that suggest rare cases of advanced dementia — we can’t tell if it’s Alzheimer’s. So, there was a progression going from the ancient Greeks to the Romans,” Finch explained.

Environmental factors and cognitive decline

Finch, alongside co-author Stanley Burstein, a historian at California State University, Los Angeles, postulates that the denser Roman cities and increased pollution might have escalated cognitive decline cases.

The use of lead in cooking vessels, water pipes, and even wine sweetening by Roman aristocrats likely exacerbated the issue, given lead’s neurotoxic properties.

To further their understanding, Finch didn’t limit his research to the ancient Western world. Lacking demographic data for ancient Greece and Rome, he turned to a modern comparison: the Tsimane Amerindians of the Bolivian Amazon.

The Tsimane’s preindustrial, physically active lifestyle mirrors that of the ancient civilizations, and significantly, they exhibit extremely low dementia rates.

An international team, including Margaret Gatz, a professor at the USC Leonard Davis School, found that only about 1% of older Tsimane people suffer from dementia, a stark contrast to the 11% incidence in the United States’ elder population.

Rethinking dementia in the light of history

In summary, this comprehensive study, bridging ancient texts and contemporary groups, underscores the profound impact of environmental factors on dementia risk throughout history.

The Tsimane community offers a valuable model for understanding how lifestyle choices influence cognitive health.

As Finch notes, their minimal dementia rates provide a template for asking critical questions about the environment’s role in this modern-day health challenge.

“The Tsimane data, which is quite deep, is very valuable,” Finch said. “This is the best-documented large population of older people that have minimal dementia, all of which indicates that the environment is a huge determinant on dementia risk. They give us a template for asking these questions.”

This research revisits our historical understanding of dementia while providing suggestions for future studies, potentially reshaping our approach to preventing and managing this condition in the modern world.

More about the history of dementia

As discussed above, dementia describes a group of symptoms affecting memory, thinking, and social abilities severely enough to interfere with daily functioning.

Dementia is not a single disease but rather a general term that encompasses various specific medical conditions, including Alzheimer’s disease, observed throughout history.

This horrible infliction results from damage to brain cells, which affects their ability to communicate with each other, thereby affecting behavior, feelings, and thoughts.

Causes and risk factors

Several factors contribute to the development of dementia. Age is the most significant risk factor, with most cases occurring in people 65 years or older.

However, dementia can also affect younger people. Genetic factors play a role, as certain types of dementia run in families.

Other risk factors include smoking, excessive alcohol consumption, cardiovascular diseases, diabetes, and obesity. Traumatic brain injury may also increase the risk of developing certain types of dementia.

Symptoms of dementia

The symptoms of dementia vary widely, depending on the cause and the area of the brain that’s affected.

Common signs include memory loss, difficulty in planning or solving problems, confusion with time or place, challenges in understanding visual images and spatial relationships, problems with speaking or writing, and changes in mood or personality.

As dementia progresses, individuals may have difficulty performing everyday tasks and may become more dependent on others for care.

Diagnosis and treatment

Diagnosing dementia involves a thorough medical evaluation, including medical history, physical examination, laboratory tests, and sometimes brain imaging studies.

While there is no cure for most types of dementia, treatment can help manage symptoms. Medications may be prescribed to improve symptoms related to memory, thinking, sleep disturbances, and behavior changes.

Non-pharmacological therapies, such as cognitive stimulation, exercise, and activities tailored to the individual’s interests and abilities, can also be beneficial.

Living with dementia

Living with dementia poses significant challenges for individuals and their families. It requires adjustments to living arrangements, daily routines, and communication methods.

Support from healthcare professionals, social workers, and support groups can be invaluable in managing the disease.

Creating a safe, supportive environment and maintaining a routine can help individuals with dementia feel more secure and less confused.

In summary, dementia is a complex condition that affects millions of individuals and their families worldwide.

While it has been anecdotally present throughout human history, it has become increasingly common in the modern age.

Early diagnosis and appropriate care strategies can help improve the quality of life for individuals with dementia and provide support for their caregivers.

The full study was published in the Journal of Alzheimer’s Disease.

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