Dementia may not have been a common illness among the elderly in Ancient Greece, but when the Roman Empire was at its peak, it started to become apparent, according to a new study.

The research, published in the Journal of Alzheimer’s Disease, has found very few references to dementia-like conditions among ancient medical texts, despite finding other common ailments of the elderly like hearing loss.

“The ancient Greeks had very, very few – but we found them – mentions of something that would be like mild cognitive impairment,” says first author Caleb Finch, a professor at the University of Southern California’s Leonard Davis School of Gerontology.

“When we got to the Romans, and we uncovered at least 4 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 and colleagues examined medical writing from both ancient civilisations, including work from the Greek physician Hippocrates and his followers, and the Roman physicians Galen and Pliny the Elder.

The Greek writings suggested that minor memory issues, something modern physicians would call mild cognitive impairment, were common among aged populations. They also described problems like hearing loss, dizziness, and digestive problems.

But there were no mentions of more serious memory loss as the type that might be caused by Alzheimer’s disease or other similar conditions.

Roman texts did occasionally mention more dementia-like conditions, such as the story of Valerius Messalla Corvinus, who forgot his own name.

The researchers believe that air pollution and lead exposure, both of which have been tentatively linked to dementia, may be the reason behind these trends. The Roman Empire saw increasing levels of lead use in pipes and cookware, as well as bigger cities, which might explain the appearance of dementia cases in Rome compared to Greece.

They suggest that another piece of evidence driving this is the low levels of dementia among a modern Indigenous population, the Tsimane people of Bolivia, who live a highly active preindustrial lifestyle.

“The Tsimane data, which is quite deep, is very valuable,” says Finch.

“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.”

In 2022, the Australian Institute of Health and Welfare estimated there were 401,300 Australians living with dementia. This correlates to 84 people per 1,000 over the age of 65.

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