Did the ancient Greeks and Romans experience Alzheimer's?
today.usc.edu
today.usc.edu
> "Conclusions: The modern 'epidemic level' of advanced dementias was not described among ancient Greco-Roman elderly. The possible emergence of advanced ADRD in the Roman era may be associated with environmental factors of air pollution and increased exposure to lead. Further historical analysis may formulate critical hypotheses about the modernity of high ADRD prevalence."
Air pollution has near-zero explanatory power, though. See: "Global, regional, and national burden of Alzheimer's disease and other dementias, 1990–2019" at: https://www.frontiersin.org/articles/10.3389/fnagi.2022.9374...
"High-income North America" has the highest age-standardized incidence rate, whereas smog-shrouded South Asia has the lowest. East Asia, infamous for industrial and urban air pollution, is also fairly low on the list. From this data, there's apparently zero correlation between pollution and incidence rate.
Leaded gas for example has seen a huge decline, but was still a thing when current 70+ year olds where young. Similarly, current developing economies where very different 50 years ago.
There's also a paper which reviews the "global incidence of young-onset dementia" -- and, again, incidence in the low-pollution USA is higher than in high-pollution developing countries. https://alz-journals.onlinelibrary.wiley.com/doi/full/10.100...
So you’d probably need to look at people in their 50s who really had an impact of lead from auto fuel.
[0] https://www.greencarreports.com/news/1133434_why-did-the-wor...
I had summer jobs at gas stations in the early 90s and maybe 10% of the fuel sold was leaded.
Roman bones also show much higher levels of copper. It is well documented that the brains suffering from Alzheimer's lack copper. (from autopsies)
It's not as if they were doing detailed demographic studies back then, though. There's just certain things that can't be known, and this is one of them.
If it were a prison disease, surely with ~2 billion data points of those with/without dementia, we would have isolated exactly what molecule causes it and how it gets transmitted from person to person.
Track the incentives.
Anyway, the cause seems to be nutritional. People used to consume vastly more copper than we do today. The modern recommended intakes were hastily made up for the need in the WW2, and never seriously revised.
„They Were Labeled Witches. They Just Had Dementia“, https://narratively.com/they-were-labeled-witches-they-just-...
Discussed in 2021: https://news.ycombinator.com/item?id=27343868
This might be interesting because here people with dementia were not classified as suffering from cognitive impairment but as witches. It went as far as considering dementia purely a white people disease that didn’t occur in Africa. Maybe the Greeks and Romans did similar mistakes (e.g. treating them as seers, oracles or such)?
I have to think people reaching that advanced an age was relatively rare in pre industrial times, coupled with the fact that today Alzheimer’s affects only about 10% at age 65. You would need a large population reaching that age and beyond to the later stages where the disease becomes problematic before it would become noticeable in a society.
60 - 70 seemed to be the upper ceiling for a very long time.
Being poor, however, has always sucked. Being wealthy always meant you lived longer.
The difference is that wealth concentration was much more strongly localized and concentrated in the past. And the famous people, who you have heard of, were generally the more wealthy people.
For instance…my father about 4 years ago lost all ability to successfully use a TV remote, telephones (To call), to drive, etc. He could read, was able to eat, handle self hygiene needs, etc. Our society notices the decline sooner because of the tech we use. However, 2000 years ago, the decline may not have been as noticeable until it hit the most advanced stages. At the advanced stages, hygiene, eating, etc… become difficult to impossible and these later stages back then would likely bring quicker physical declines and death than they do today.
But I suppose if the dementia appears as an acquired condition then having some ominous description for the victim would help avoid the spread of whatever contamination or infection that could have been an explanation.
Currently, this figure is 43% worldwide from birth. But fertility is also way lower as a response to low infant and child mortality.
So 3.5x increase in over-70 population seems a decent guesstimate. In developed countries even more.
In a study of all men of renown, living in the 5th and 4th century in Greece, we identified 83 whose date of birth and death have been recorded with certainty. Their mean +/- SD and median lengths of life were found to be 71.3+/-13.4 and 70 years, respectively.
Dementia starts to be noticeable in modern society after about 75. I haven't found a source showing the distribution of age at diagnosis.
Also the title is highly misleading: Alzheimers is only one form of dementia.
From another source:
A growing number of studies indicate that the prevalence 223.267.315-322 and incidence270.320-329 of Alzheimer's and other dementias in the United States and other higher income Western countries may have declined in the past 25 years,270,277.320-328.330-333 though results are mixed. 60.261.334-335 One recent systematic review found that incidence of dementia has decreased over the last four decades while incidence of Alzheimer's dementia, specifically, has held steady[1]: not the best source, but one I could find now: https://www.tandfonline.com/doi/full/10.3109/07853890.2011.5...
Not that either of these are good or necessary for a healthy species, mind you. We will always adapt to our environment and the selective pressures that match it, even when it's one of our own making. If that means fewer children die young, that is an excellent outcome - evolution is never goal oriented anyway.
This would be an issue if Alzheimers is part of a phenotype that raises all-cause mortality in the young. I'm not aware of any research on this. Alzheimers is known to be correlated with certain lifestyle and immune factors, and these factors might be expressions of a common phenotype that also increases early mortality and is moderated by pre-industrial environments---e.g. increased risk-taking or decreased immunity.
A common phenotype hypothesis might explain some of the difference in Alzheimers incidence between Tsimane and Westerners, but it would be surprising if it were the main reason. Assuming the hypothesis only, an Alzheimers delta of 11x for those over 65 implies a mortality rate delta of 11x between the under-65 phenotype groups. That is a massive effect, and if it includes child mortality, we would expect to see genetic drift over time and a lower genetic predisposition to Alzheimers among Tsimane (has that been studied?).
Both of my grandpas worked manual labor their entire lives. One had Alzheimer's, the other started to develop dementia but is on medicine now.
Interesting thing to note, both were extremely intelligent. Seems like the more intelligent of my extended family were also more likely to have memory issues.
(To those curious, one was a logger, the other was a plumber.)
And they were certainly breathing lots of smoke from their cooking fires. Although wood smoke is probably less hazardous than two stroke oil.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5810277/
: Scientific evidence has shown that metal ion binding to β-amyloid accelerates amyloid aggregation, which could finally damage the neurons in AD (Pithadia and Lim, 2012). The involvement of copper in AD is controversial, as some studies show copper deficiency in AD, and consequently a need to enhance copper levels (Borchardt et al., 1999; Kessler et al., 2005, 2008a,b; Exley, 2006; Jiao and Yang, 2007; Vural et al., 2010; Kaden et al., 2011; Exley et al., 2012), while other data point to copper overload and therefore a need to reduce copper levels (Cherny et al., 2001; Sparks et al., 2006; Hua et al., 2011; Luo et al., 2011; Ceccom et al., 2012; Eskici and Axelsen, 2012; Brewer, 2014; Squitti et al., 2014b; Yu et al., 2015). An aberrant copper homeostasis with an increase in the labile pool of copper and a decrease in the copper bound to protein is the main up-dated interpretation (Kepp, 2016; Squitti et al., 2016). In this paper, the role of metal ions, particularly copper, in AD is reviewed and discussed.
I spot checked starting from newer to older the too much copper citations and the third one I checked, "Brewer, 2014", though it itself cites animal studies, was about copper in humans (specifically inorganic copper as a hypothesized problem, versus organic copper which he says is fine). The Brewer paper references "Squitti et al., 2005" which was a study of humans showing elevated copper (of inorganic origin? I didn't read further than the abstract) and a couple of other things in Alzheimer's patients.
So copper from food? Good. Copper from water pipes? Bad. Chelated copper from supplements? I don't know. Maybe further reading would show other results. Again, I just skimmed this.
There is literally no reason to believe this. Plus, the amounts leeched from pipes are nowhere near high enough to provide even the paltry RDA. People used to cobsume more. They used to use bronze or copper cookware. It's bullshit. You are only coming up with excuses why it isn't copper. Why? I suppose because the cure would be almost free.
Brewer disagrees (copper from pipes or cookware is inorganic copper).
> You are only coming up with excuses why it isn't copper.
I genuinely don't know. I just found your claim interesting and searched for articles on it. And what I found is conflicting information.
I don't care. It's unreasonable. There is no such a thing as "organic copper". People used to use those much more. There is no good correlation between blood levels and copper status. The actual levels in the actual brains show the opposite in autopsies.
Also, manual labor isn't the same as cardiovasular exercise and it is possible (and likely much easier these days with all of the powered machinery and transport) to not get much cardiovascular exercise despite a physically intensive job. Although I'm guessing even today a logger would.
This is speculation but it wasn't until the past 70 or so years that large amounts of people were able to be sedentary.
I know the "simple explanation for why everything is fucked up" answer is almost always wrong but I'm very convinced that lack of walking is a major contributor to all of this stuff.
... If dementia sets in, there will be no failure of such faculties as breathing, feeding, imagination, desire: before these go, the earlier extinction is of one's proper use of oneself, one's accurate assessment of the gradations of duty, one's ability to analyse impressions, one's understanding of whether the time has come to leave this life - these and all other matters which wholly depend on trained calculation. So we must have a sense of urgency, not only for the ever closer approach of death, but also because our comprehension of the world and our ability to pay proper attention will fade before we do.
as most dementia is found among individuals ≥ 75 years of age, the pyramid-shaped age structure of the Tsimane and Moseten populations means that the crude prevalence would be expected to be low.
Relatively low exposure to traffic and industrial sources of environmental pollution are offset to an unknown extent by cooking fires and biomass burning.
Evidence is converging as to the major modifiable risk factors for dementia and AD.5, [6] These include low formal education[7]; vascular factors, including midlife hypertension and diabete[8]; cardiovascular disease other than stroke[9]; physical inactivity[10]; and—a recently recognized addition—air pollution.[6] Higher coronary artery calcium (CAC) scores—a marker of atherosclerosis—is related to increased risk of dementia.[11] Evidence-based dietary recommendations for reducing risk of dementia and AD include regular consumption of fresh vegetables, fruits, and fish.[12] In addition, several microbial pathogens have been associated with AD.
In a study of all men of renown, living in the 5th and 4th century in Greece, we identified 83 whose date of birth and death have been recorded with certainty. Their mean +/- SD and median lengths of life were found to be 71.3+/-13.4 and 70 years, respectively.Indoor air pollution was astronomically higher when people were gathered around a warm hearth.
The green movement is therefore putting lots of effort into researching this topic.
This isn’t a criticism of the research.
Research into tobacco harms thrived on the political opposition to big companies.
Nevertheless lots of life saving findings came out of it.
https://www.pnas.org/doi/10.1073/pnas.2205448120
[Significance]
This article explores brain volume and aging in two indigenous societies. Whereas brain volume is lower with greater body mass index (BMI) in industrialized populations, the association of BMI and non-HDL cholesterol with brain volume is largely positive, only declining with high BMI and cholesterol. This discrepancy represents a form of evolutionary mismatch we call an “embarrassment of riches” due to recent changes in diet, activity, and other environmental exposures. The minimal dementia and coronary artery disease in Tsimane and Moseten, combined with these findings, imply that aging outcomes are optimized at intermediate lifestyle values. Future research should focus on how our evolved biology interacts with conscious goals in relation to eating, exercise, and physiology.
[Abstract]
Little is known about brain aging or dementia in nonindustrialized environments that are similar to how humans lived throughout evolutionary history. This paper examines brain volume (BV) in middle and old age among two indigenous South American populations, the Tsimane and Moseten, whose lifestyles and environments diverge from those in high-income nations. With a sample of 1,165 individuals aged 40 to 94, we analyze population differences in cross-sectional rates of decline in BV with age. We also assess the relationships of BV with energy biomarkers and arterial disease and compare them against findings in industrialized contexts. The analyses test three hypotheses derived from an evolutionary model of brain health, which we call the embarrassment of riches (EOR). The model hypothesizes that food energy was positively associated with late life BV in the physically active, food-limited past, but excess body mass and adiposity are now associated with reduced BV in industrialized societies in middle and older ages. We find that the relationship of BV with both non-HDL cholesterol and body mass index is curvilinear, positive from the lowest values to 1.4 to 1.6 SDs above the mean, and negative from that value to the highest values. The more acculturated Moseten exhibit a steeper decrease in BV with age than Tsimane, but still shallower than US and European populations. Lastly, aortic arteriosclerosis is associated with lower BV. Complemented by findings from the United States and Europe, our results are consistent with the EOR model, with implications for interventions to improve brain health.
Am I missing something?
If you made it past your tenth birthday, you had a 50% chance of making it to 50, and a 25% chance of making it to 65.
En masse, that makes for an amply large population of people in the age range for dementia to draw conclusions.
https://en.m.wikipedia.org/wiki/Demography_of_the_Roman_Empi...
Infant mortality rates were dramatically higher in the past and drag that average way down, for instance, say I have a 1 day old infant, and a 100 year old person and they both die, they have a combined 'average life expectancy' of 50 years old. But, once you made it out of the 'childhood illness' mortality stage, most folks could expect to see 70 years old.
https://sc.edu/uofsc/posts/2022/08/conversation-old-age-is-n...
- obesity
- cancer
- depression, ADHD, autism, gender dysphoria
- dementia
Occam's law applies.
Careful with those absolutes. That linked article overall discusses obesity as a likely risk factor for it. On the sugar point, "sucrose" only appears once in the piece and the referenced study involved mice, not humans.
“Currently, there is a rapid growth in the literature pointing toward insulin deficiency and insulin resistance as mediators of AD-type neurodegeneration, but this surge of new information is riddled with conflicting and unresolved concepts regarding the potential contributions of type 2 diabetes mellitus (T2DM), metabolic syndrome, and obesity to AD pathogenesis.”
https://www.mdpi.com/2227-9059/12/1/99
Part of why that matters is that you will have no trouble finding people who ate little sugar and still developed it, or sweet fiends who didn’t, and presenting such a simple explanation can feel cruel to people who saw their loved ones die a pretty ugly death since it sounds like you’re saying it’s a choice.
This wasn’t a children of the corn situation.