Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
Department of History, California State University, Los Angeles, CA, USA.
J Alzheimers Dis. 2024;97(4):1581-1588. doi: 10.3233/JAD-230993.
The possibility that Alzheimer's disease and related dementias (ADRD) is a modern disease arises from the minimal mention of advanced cognitive decline by ancient Greeks and Romans, who were mainly concerned with the physical frailties of older ages.
Because standard medical histories of elderly health lacked mention of cognitive decline, we examined texts by Greek and Roman authors that mentioned memory loss and dementia.
Primary texts of Greco-Roman authors, 8th century BCE into the 3rd century CE, that mentioned cognitive decline were identified and critically evaluated. Secondary sources were excluded.
No ancient account of cognitive loss is equivalent to modern clinical data. The term dementia was occasionally used in antiquity, but not invariably linked to old age. Ancient Greeks and Romans expected intellectual competence beyond age 60. While some memory loss was acknowledged, we found only four accounts of severe cognitive loss that might represent ADRD. The possibility of modest ADRD prevalence in ancient Greece and Rome is consistent with its low prevalence in the Tsimane of Bolivia. These contemporary Amerindians live under conditions of high mortality from frequent infections and minimal cardiovascular disease with physically demanding lives. Tsimane after age 60 had increased mild cognitive impairment; the few cases of dementia were not clinically consistent with AD.
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.
阿尔茨海默病和相关痴呆症（ADRD）是否为一种现代疾病，这一可能性源于古希腊和古罗马人对认知能力严重衰退的记载甚少，他们主要关注的是老年时期的身体脆弱性。
由于标准的老年健康病史很少提及认知能力下降，我们研究了古希腊和罗马作者提到记忆丧失和痴呆的文本。
确定并批判性地评估了提到认知能力下降的古希腊罗马作者的主要文本，时间范围从公元前 8 世纪到公元 3 世纪。排除了次要来源。
没有任何关于认知丧失的古代记载与现代临床数据相当。在古代，痴呆症这个术语偶尔被使用，但并不总是与老年相关。古希腊人和罗马人期望在 60 岁以后仍保持智力能力。虽然承认存在一定程度的记忆丧失，但我们只发现了四个可能代表 ADRD 的严重认知丧失的案例。在古希腊和罗马，适度的 ADRD 患病率较低，这与玻利维亚提斯曼人的患病率较低是一致的。这些当代的美洲印第安人生活在高死亡率的环境中，频繁受到感染，心血管疾病很少，生活需要大量体力。60 岁以后的提斯曼人有轻度认知障碍增加；痴呆症的少数病例在临床上与 AD 不一致。
在古希腊罗马的老年人中，没有描述过晚期痴呆症的现代“流行水平”。在罗马时代，晚期 ADRD 可能的出现可能与空气污染和铅暴露增加等环境因素有关。进一步的历史分析可能会提出关于高 ADRD 患病率现代性的关键假设。
