[HN Gopher] Did the ancient Greeks and Romans experience Alzheim...
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       Did the ancient Greeks and Romans experience Alzheimer's?
        
       Author : joveian
       Score  : 51 points
       Date   : 2024-02-11 16:41 UTC (6 hours ago)
        
 (HTM) web link (today.usc.edu)
 (TXT) w3m dump (today.usc.edu)
        
       | _Microft wrote:
       | Maybe this is an interesting article in this context:
       | 
       |  _,,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)?
        
         | readthenotes1 wrote:
         | Or maybe the people with dementia died off early in the cycle
         | before it became pronounced enough for other people to truly
         | notice and remark on it. Life is much safer nowadays and we
         | tend to forget all the guardrails we have up for everyone
        
       | genter wrote:
       | > with sedentary behavior and exposure to air pollution largely
       | to blame.
       | 
       | 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.
        
         | anonymouskimmer wrote:
         | You edited out their jobs, but I saw before the edit. Without
         | restating those jobs I'll say that one would have had exposure
         | to emissions from 2-cycle mixed oil/gasoline engines. The other
         | would have had exposure to lead solder fumes.
        
           | genter wrote:
           | I edited that out because I thought it was superfluous, but
           | you're right. Also the plumber smoked.
           | 
           | (To those curious, one was a logger, the other was a
           | plumber.)
        
             | genter wrote:
             | Upon further thought, the Romans were exposed to lead,
             | their water pipes were made from lead (installed by
             | plumbers), not to mention pewter and bronze objects.
             | 
             | And they were certainly breathing lots of smoke from their
             | cooking fires. Although wood smoke is probably less
             | hazardous than two stroke oil.
        
       | tptacek wrote:
       | This article uses the example of the Tsimane people of Bolivia as
       | a model for pre-industrial society, and notes that a very low
       | percentage of older Tsimane experience measured dementia
       | (something like 1% compared to 11% in North America). But it's
       | also the case that the at-birth life expectancy of a Tsimane
       | person is quite low compared to the rest of North America; a
       | smaller percentage of Tsimane survive to the age at which
       | Alzheimers becomes a major epidemiological issue in modern
       | societies. How does a researcher account for that? It seems like
       | it could be a confounder.
        
         | Detrytus wrote:
         | But wasn't that also the case in antiquity/middle ages? People
         | not experiencing Alzheimer's because they did not live long
         | enough?
        
           | tptacek wrote:
           | Right, so the premise of the article is an inquiry into
           | whether there is something neuroprotective about the
           | lifestyle or environment of premodern civilization.
        
           | anonymouskimmer wrote:
           | I'm guessing that Cicero, Galen, et al. would have primarily
           | been looking at upper-crust Romans. Tribal groups are
           | necessarily more equal.
        
           | Gare wrote:
           | It is estimated that about 12% of Romans that survived first
           | 10 years of life (half of them died before that, but _cest la
           | vie_ if you don 't have vaccines and antibiotics) lived to be
           | 70 years or older.
           | 
           | 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.
        
         | randallsquared wrote:
         | Do you suspect a higher percentage of those of the Tsimane who
         | died young would have developed dementia after 65 (which seems
         | to be the cutoff they're using)? That would be an interesting
         | result, but unless there's some reason to think it, it's just
         | one of many potential hypotheses.
        
           | tptacek wrote:
           | I don't know! I think the subtext of the article is that the
           | Tsimane have, _ceteris paribus_ , a lower incidence of
           | dementia --- that if you could keep the lifestyle and
           | environment constant and raise the at-birth life expectance
           | of these people to modern standards, they'd still have low
           | rates of dementia. I'm wondering if that's true, and how
           | you'd go about investigating that.
        
         | EnigmaFlare wrote:
         | I often wonder what the effects of reduced infant mortality
         | will be on the population. For all of human history before
         | about 100 years ago, we were aggressively selected for survival
         | at birth or shortly after. Now, we're not. All those people who
         | would have died might not only suffer other health problems in
         | their life but propagate the "die as a baby" genes to their
         | offspring. Optimistically, it might mean that humans both
         | become dependent on those medical technologies that save babies
         | and mothers, and maintain the capability to provide them so
         | we're fine. It could be a positive direction for evolution,
         | like how we're already adapted to depend on ancient
         | technologies like housing, clothing, and cooking. But maybe
         | it's just bad and future generations will be generally get less
         | and less healthy.
        
           | tomthe wrote:
           | The head sizes of babies are actually getting larger over the
           | past decades [1]. This might be because of better nutrition,
           | but maybe it is by a large part because we can do caesarean
           | sections in every hospital now and head size is not as
           | limited as it was before anymore.
           | 
           | [1]: not the best source, but one I could find now: https://w
           | ww.tandfonline.com/doi/full/10.3109/07853890.2011.5...
        
         | ramblenode wrote:
         | > a smaller percentage of Tsimane survive to the age at which
         | Alzheimers becomes a major epidemiological issue in modern
         | societies. How does a researcher account for that? It seems
         | like it could be a confounder.
         | 
         | 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?).
        
       | cubefox wrote:
       | So far I heard mention of unknown environmental contaminants as
       | suspected causes for rising rates of:
       | 
       | - obesity
       | 
       | - cancer
       | 
       | - depression, ADHD, autism, gender dysphoria
       | 
       | - dementia
        
         | lanstin wrote:
         | All worth exploring. You forgot low sperm production. We are
         | surrounded by manufactured molecules that mimic hormones from
         | our bodies, an experiment with not much of a control group, and
         | an experiment where the naive materialist model would lead one
         | to expect effects.
        
         | stevenwoo wrote:
         | Asthma, IIRC there was also a study that showed just living
         | adjacent to roads with high truck traffic caused sizable
         | increases in percent of children who developed asthma compared
         | to other local neighborhoods.
        
       | A_D_E_P_T wrote:
       | Here's the abstract of the actual paper:
       | https://pubmed.ncbi.nlm.nih.gov/38277296
       | 
       | > "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.
        
         | Retric wrote:
         | Current air pollution levels isn't indicative of lifetime or
         | especially childhood exposure.
         | 
         | 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.
        
           | A_D_E_P_T wrote:
           | Sure, but even so it's not clear that air pollution is a
           | factor. Some researchers recently compiled a "chronology of
           | global air quality" which might be worth a review to see if
           | any correlations can be uncovered. At a glance, it looks to
           | me as though Europe and the USA cleaned up their act a long
           | time ago -- so unless pollution exposure _in early childhood_
           | is somehow especially bad, pollution still has no explanatory
           | power: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7536029/
           | 
           | 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...
        
           | beAbU wrote:
           | Leaded gas was a thing when current 30 year olds were young.
        
             | smcin wrote:
             | Surely studies could get a good control group of people who
             | grew up in rural Montana, or the Andes. Assume we can find
             | groups with near-zero lifetime exposure to atmospheric
             | (and/or waterborne) lead. What's their background rate of
             | Alzheimer's?
        
             | prepend wrote:
             | Not really [0], leaded gas was completely banned in the US
             | in 1996 but really hadn't been used since the early 80s and
             | had start the phase out in 1996.
             | 
             | 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...
        
               | argiopetech wrote:
               | Where "completely" in this case implies "for road-going
               | vehicles". General aviation (largely small, piston-engine
               | planes) still overwhelmingly run on 100 octane low-lead
               | (100LL).
        
           | bparsons wrote:
           | This is correct. Environmental accumulation would be highest
           | in the areas that industrialized first.
        
         | Systemling0815 wrote:
         | Good point, you should immediately notify the UCLA
         | gerontologists of their major scientific blunder.
        
           | A_D_E_P_T wrote:
           | _Nullius in verba_. You 'd be well advised to take a
           | skeptical view of every scientific paper -- especially those
           | promoted by University PR departments.
           | 
           | Besides, "it's air pollution's fault" was a throwaway
           | statement by those UCLA gerontologists. It wasn't the focus
           | of their study; it was simply an unsupported notion of what
           | might explain the supposedly higher rate of Alzheimer's
           | disease in Rome as opposed to Ancient Greece. (I write
           | _supposedly_ because they don 't really have enough for a
           | statistically valid conclusion. What they have is: "In the
           | writings that have survived, the Greeks mentioned something
           | like Alzheimer's once. The Romans mentioned it four times.
           | Now what could account for this presumptive discrepancy?
           | We'll assume that it could have been lead or dirtier air.")
        
           | readthenotes1 wrote:
           | Scientific? It's just career manure until it's been
           | replicated
        
           | malux85 wrote:
           | It has been MANY, MANY years since the alignment of academic
           | institutions was solely meritorious, perverse incentives
           | distort truth regardless of infomation source.
        
       | marcinzm wrote:
       | I'm curious about the day to day environment the Tsimane live in
       | since I can see a relationship between dementia and increased
       | accidental deaths in more dangerous environments. Let's say you
       | need to walk 5 miles a day through a predator infested jungle for
       | water. Getting lost one day due to an episode of dementia could
       | easily kill you. Same for eating a poisonous plant or drinking
       | water from the wrong source or even getting a simple cut that
       | becomes infected due not paying attention. The study used 65 as a
       | cutoff which is before most physical deteriorations so
       | individuals are likely still self-reliant.
        
       | frozenport wrote:
       | Whats up with the fixation on air pollution?
       | 
       | Indoor air pollution was astronomically higher when people were
       | gathered around a warm hearth.
        
         | e44858 wrote:
         | Air pollution had high amounts of lead before leaded gasoline
         | was banned in cars. Lead is way more toxic than wood smoke.
        
           | frozenport wrote:
           | Yeah but as the article mentioned this wasn't really a issue
           | until the Romans were conquered by the Lombards and their
           | nearly invincible Lamborghinis.
        
         | spacebanana7 wrote:
         | The more problems that can be attributed to air pollution, the
         | stronger the argument against cars/industry.
         | 
         | The green movement is therefore putting lots of effort into
         | researching this topic.
        
       | acadapter wrote:
       | The first part of Book 3 in Marcus Aurelius' Meditations has this
       | description of "dementia".
       | 
       | ... 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.
        
       | brigadier132 wrote:
       | There is evidence that cardiovascular exercise results in
       | neurogenesis which results in lower incidences of dementia in
       | older adults.
       | 
       | 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.
        
       | mensetmanusman wrote:
       | Alzheimer's is a side effect of a sugar rich diet.
       | 
       | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9099768/
        
         | jjulius wrote:
         | >Alzheimer's is a side effect of a sugar rich diet.
         | 
         | 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.
        
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