Could Our Modern Way of Life Be Behind Alzheimer's? Exploring the Ancient World's Understanding of Dementia

The review published in the Journal of Alzheimer's Disease explores the ancient Greek and Roman understanding of dementia, drawing from medical-philosophical texts and literary sources. It finds that while there were no dedicated texts on dementia, these sources provided detailed descriptions of symptoms resembling modern dementia. The ancients recognized a spectrum of cognitive impairments, including memory loss, personality changes, and delirium. Their understanding was rooted in the concepts of humoral imbalances and the mind-body connection. While lacking modern scientific tools, their insights offer valuable historical perspectives on the origins of our contemporary understanding of dementia.

Key points

1. Early recognition of dementia symptoms: The ancient Greeks and Romans described symptoms like memory loss, personality changes, and delirium, which closely resemble modern dementia.

2. Humoral theory as a framework: They used the concept of humoral imbalances (fluids like blood, phlegm, yellow bile, and black bile) to explain the causes of various diseases, including mental decline.

3. Spectrum of cognitive impairments: The ancients recognized that age-related mental decline could vary in severity, from mild memory loss to more severe conditions like delirium.

4. Mind-body connection: Their understanding of dementia was influenced by their belief in the interconnectedness of the mind and body.

5. Moral and philosophical perspectives: Literary sources often addressed the moral and philosophical implications of cognitive aging, exploring themes like wisdom, experience, and the acceptance of death.

6. Limitations of ancient knowledge: The ancients lacked modern scientific tools like neuroimaging and genetic analysis, which have significantly advanced our understanding of dementia.

7. Historical significance: The ancient Greek and Roman sources provide valuable insights into the origins of our contemporary understanding of dementia, offering a richer and more nuanced perspective on this complex condition.

Ancient Understanding of Dementia: From Plato to Seneca

While modern medicine has made remarkable progress in diagnosing, understanding, and treating conditions like dementia, the origins of our contemporary concepts can be traced back thousands of years to the writings of ancient Greek and Roman physicians and philosophers. Contrary to the common misconception that dementia was not recognized or described in the classical world, a closer examination of the medical and literary works from this era reveals a surprisingly sophisticated understanding of the cognitive and behavioral symptoms associated with age-related mental decline.

The article begins by noting that while there are no ancient texts devoted solely to the "advanced loss of intellectual abilities," numerous important sources from the Greco-Roman period do contain detailed descriptions of symptoms that closely resemble what we now categorize as dementia. The authors divide these ancient writings into two broad categories: medical-philosophical texts, including the works of Plato, Aristotle, Hippocrates, and Galen, and literary sources, such as the writings of Cicero, Seneca, Juvenal, and Marcus Aurelius.

In the medical-philosophical domain, the ancient Greeks developed a comprehensive concept of bodily humors—fluids like blood, phlegm, yellow bile, and black bile—and believed that an imbalance or "wandering" of these humors could give rise to various psychopathological phenomena. For example, the philosopher Plato, writing around 400 BCE, explained that "whenever the humours that arise from acid and saline phlegms, and all humours that are bitter and bilious wander through the body... they generate all manner of diseases, and, above all, disturb the courses of the soul, filling her with confusion and replenishing her with a thousand other ills."

This holistic, humoral understanding of the mind-body connection provided a framework for interpreting the cognitive and behavioral symptoms associated with aging. The ancient Greek physician Aretaeus, writing in the 2nd century CE, described patients exhibiting "forgetfulness of recent events" and "loss of memory," while also noting changes in personality, such as "a childish disposition, loss of shame, and indecency." These symptom profiles bear a striking resemblance to how we today would characterize different forms of dementia.

Importantly, the ancients did not view these age-related mental declines as a single, uniform condition, but rather recognized a spectrum of cognitive and functional impairments. The renowned encyclopedist Celsus, writing in the 1st century CE, distinguished between milder forms of memory loss and more severe cases involving "delirium" and the inability to "recognize either persons or places." This early differentiation of dementia-like syndromes anticipates the modern clinical classification of dementias into subtypes like Alzheimer's, Lewy body, and frontotemporal dementia.

While the ancient medical texts provide valuable insights into the conceptual foundations of our contemporary understanding of dementia, the literary sources offer a complementary perspective on how cognitive aging was perceived and experienced in the broader cultural context of Greco-Roman society. These works, ranging from poetry to philosophy, often adopt a moralizing tone, either lamenting the "unfortunate cognitive consequences" of old age or praising the wisdom and experience that can come with advancing years.

An early example of the former perspective can be found in a 24th-century BCE verse by the Egyptian Vizier Ptahhotep, who laments: "Eyes are dim, ears are deaf, Strength is waning, one is weary, The mouth, silenced, speaks not, The heart void, recalls not the past...What age does to people is bad in every respect." Similarly, the Roman satirist Juvenal, writing in the 2nd century CE, bemoans the mental and physical decline of old age, observing that "the mind itself grows old and withers away."

In contrast, the Stoic philosopher Seneca, writing in the 1st century CE, takes a more positive view, arguing that age can confer valuable perspective and equanimity: "Old age is an incurable disease, but one that has the advantage of slowly and gently preparing us for death." And the emperor-philosopher Marcus Aurelius, in his famous work "Meditations," celebrates the "tranquility" and "freedom from disturbance" that can come with the "decline of the life-forces."

Taken together, these ancient medical and literary sources demonstrate a nuanced and multifaceted understanding of cognitive aging in the Greco-Roman world. The physicians and philosophers of this era not only recognized the symptoms of dementia-like conditions, but also grappled with the deeper philosophical and existential questions surrounding the interplay of mind, body, and the human experience of growing old.

Of course, it would be a mistake to view these ancient concepts as identical to our modern clinical and scientific understanding of dementia. The authors readily acknowledge that "limitations of this ancient concept are due to terminological and epidemiological factors, as well as to the physicians' social role." The classical thinkers lacked the benefit of sophisticated neuroimaging, genetic analysis, and large-scale epidemiological studies that have transformed our ability to diagnose, categorize, and investigate the causes of dementia in the present day.

Moreover, the social and cultural context of the ancient world shaped the ways in which these thinkers approached and interpreted age-related cognitive decline. As the authors note, the "physicians' social"role"—their status as learned, elite members of society—likely influenced their perspectives and the way they framed these issues. And the literary works, with their moralizing and philosophical undertones, reveal how cognitive aging was enmeshed with broader cultural anxieties and conceptions of the human condition.

Nevertheless, the ancient Greek and Roman sources offer a fascinating glimpse into the origins of our modern understanding of dementia. By recovering and studying these seminal writings, we can gain a richer, more nuanced appreciation of how the concept of age-related cognitive impairment has evolved over the centuries. And in doing so, we may even uncover insights that can inform and enrich our contemporary approaches to this increasingly prevalent and deeply troubling condition.

Journal Reference:

Finch, C. E., & Burstein, S. M. (2024). Dementia in the Ancient Greco-Roman World Was Minimally Mentioned. Journal of Alzheimer's disease : JAD, 97(4), 1581–1588. https://doi.org/10.3233/JAD-230993

Image credit:https://www.emergency-live.com/it/wp-content/uploads/2020/10/Alzheimer-stimolazione-transpinale-750x430.jpg

Related:

https://healthnewstrend.com/how-anxiety-and-other-comorbidities-influence-alzheimers-disease-progression

Disclaimer

The information on this website is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.