Lifestyle Methods for Prevention of Alzheimer’s Disease From the Perspective of Traditional Persian Medicine

Abstract

Alzheimer’s disease is considered as a major problem for society health since it affects interpersonal and social relationships. With regard to the global attention toward complementary medicine, search for preventive, diagnostic, and treatment strategies in complementary medicine schools such as the old dynamic doctrine of traditional Persian medicine seems to be necessary. In this type of medicine, description and analysis of the disease and preventive and treatment methods have great importance. The present study provides a useful classification of recommendations for prevention and control of Alzheimer’s disease. Prevention is prior to the treatment and is easier and less costly. Recommendations mentioned in traditional Persian medicine texts for prevention of Alzheimer’s disease provide fields of clinical and complementary studies for researches.

Alzheimer’s disease is a chronic progressive brain disorder with major effects on memory, intelligence and the ability of self-care. This disease is associated with problems in talking, doing physical activities, recognition of scenes or familiar persons, performance, planning, innovation, and organization as well as abstract thinking. ¹ Alzheimer’s disease is considered as a major problem for society health since it affects interpersonal and social relationships. ² After the age of 65 years, its prevalence rate becomes 2-fold per each 5-year in a way that 40% to 50% of elderly older than 85 years have this disease and age increase is the most important risk factor of this disease. ³ The incidence rate of Alzheimer’s disease is increasing all around the world and is becoming a social concern in most countries. ⁴

With regard to the global attention toward complementary medicine, search for preventive, diagnostic, and treatment strategies in complementary medicine schools such as the old dynamic doctrine of traditional Persian medicine seems to be necessary. ⁵ Traditional Persian medicine is a temperament and humor-based medicine that in studying human health and illness has special attention to the temperament symptoms and 4 body humors (dam, safra, balgham, and soda). ^6,7,8 In this type of medicine, description and analysis of the disease and preventive and treatment methods have great importance. ⁷

Iran has a 1000-year history of traditional medicine. ⁶ Famous scientists of Iran, like Razi, Avicenna, Jorjani, and Aghili Khorasani, through compiling their medical findings as well as those of other nations, have suggested strategies for a lot of diseases, including Alzheimer’s disease. Identification, diagnosis, and treatment of this disease have been developed over centuries and the description of Alzheimer’s symptoms is mentioned in traditional medicine texts under the topic of forgetfulness (Nesyan). ^{9 –11}

According to traditional Persian medicine books, there are 6 essential health principles whose proper management has been long paid attention to by traditional medicine scientists. These essential principles are the following:

Air

Body movement and repose

Sleep and wakefulness

Nutrition (foods and drinks)

Excretion of unnecessary substances and retention of necessary substances

Mental movement and repose. ^6,7

With regard to the aforementioned principles, traditional Persian medicine has mentioned special issues about lifestyle of people affected with Alzheimer’s disease.

Nutrition

In traditional medicine, nutrition is the most important factor. ^7,9 Some of the general nutritional points that have been recommended by traditional medicine for all diseases, including Nesyan, are as follows:

Abstinence from overeating; eating should be done only when the person is hungry and his or her stomach has been emptied from the previous meal. Eating should be stopped before complete feeling full.

A variety of foods should be included in the diet, since continuing eating one type of food is one of the disease factors.

Abstinence from eating several type of foods in one meal.

Abstinence from severe physical activity till 1 hour after eating; the mentioned items disturb food digestion process.

Abstinence from drinking water and any liquid during meal till 1 hour after meal. ⁷

Attention to meals in different seasons.

Traditional Persion medicine’s viewpoint toward nutrition is related to both prevention and treatment aspects. Avicenna, in the first volume of Canon of Medicine, has mentioned preventive recommendations for the elderly. He recommended abstinence from black bile–producing foods such as lentil, eggplant, cow meat, dried meat, and salty foods as well as phlegm-producing foods such as fish, milk, watermelon, and cucumber. ¹⁰

Along with these preventive effects of nutrition, it has also been paid great attention as a factor facilitating the recovery process of diseases. In the treatment of Alzheimer’s disease, moderating eating foods has been recommended. Razi and some other traditional medicine scientists have suggested eating birds’ meat such as francolin, partridge, hen, pheasant, and birds’ brain and yolk in people affected by Nesyan. ¹² Among other suggested points for Nesyan, regular consumption of nuts like almond, hazel nut, and coconut are mentioned. ^9,12,13

Traditional medicine scientists have mentioned a list of foods and drinks as Nesyan-producing factors:

Onion: Razi believes that overconsumption of onion is one of the causes of Nesyan. ¹³

Sour apple: According to the traditional medicine, overconsumption of apple and eating sour apple is one of the factor of Nesyan. ¹³

Lettuce: They have mentioned overconsumption lettuce as one of the causing factors of Nesyan. ^9,14

Coriander: Consumption of coriander has been considered as etiology of Nesyan by traditional medicine scientists. ^9,14,15

Poppy: The extract of poppy skin and seed has been mentioned as the cause of Nesyan. ^9,14

Mouse: According to Traditional medicine book, consumption of mouse meat causes Nesyan. ¹⁵

Sheep brain: Regular eating of sheep brain has been mentioned by a number of traditional medicine scientists as the cause of Nesyan. ^9,14,15

Cold water: In discussion of drinks, Avicenna and Razi have mentioned overdrinking of water as cause of Nesyan.They have recommended abstinence from drinking cold water in all types of Nesyan. ¹³

Wine: Avicenna in his Canon of Medicine has emphasized on abstinence from wine in order to prevent Nesyan. ¹⁰

Physical Activity

Walking and light exercises like feet and hands movements are useful for prevention of Nesyan, while severe exercises have been forbidden. ⁹ Increasing brain activity through reading, memorizing, and reciting, which are considered as brain exercises, has been suggested for prevention of Nesyan. ¹⁰

Excretion of Unnecessary Substances ad Retention of Necessary Substances

Detoxification from substances produced inevitably during foods digestion and metabolism as well as retention of essential substances are beneficial for health.

Detoxification is 2 types:

Natural detoxification: through urination, defecation, sweating, menstrual cycle, vaginal discharge, and semen. These are beneficial if present in normal rate, while decrease or increase of each can cause problems.

Unnatural detoxification: it is done by medical interventions such as inducing diarrhea, sweating, and urination or performing Hijama (wet cupping). ^6,7

Excessive intercourse is forbidden in Nesyan. Excessive bathing or washing body with cold or hot water is also forbidden. ^9,10 Hijama is a type of blood taking that is done on a specific area based on the disease. One type of Hijama is noghre Hijama performed on the noghre site (below the occipital bone). Avicenna has considered noghre Hijama due to the induced memory deficit after it. ¹⁰

Sleep and Wakefulness

Sleep is one of the essential items of a healthy life, but the amount of it varies based on each person and age group. Sleep strengthens physical and psychological powers. The balance of sleeping and awaking is essential for health and each of which in excess cause disease. In the elderly, adequate rest is more beneficial. ^6,7 Sleeplessness, especially during night has been forbidden. ^9,10 Excessive sleeplessness has been mentioned as cause of Nesyan. ^9,12 Avicenna believes that excessive sleeplessness leads to Nesyan and also he has said that excessive sleep, especially with full stomach aggravates Nesyan. ¹³ Excessive sleep during day, especially with full stomach as well as excessive sleeplessness have been mentioned as risk factors of Nesyan by Razi. ¹³

Mental Movement and Repose

Human humor is severely affected by mood. Anger, anxiety, sorrow, shame, and fear are some of normal states of body and occurrence of each causes humor balance, while increase or decrease of each causes problem. ^6,7 Abstinence from sorrow and participating in happy parties have been recommended in all types of Nesyan. Listening to joyful voices, smelling flowers, and tonic perfumes like dog rose, jasmine, lily, wallflow, lotus, bitter orange, and pussy willow; fruits like apple; and herbs like marjoram has been also been recommended. ^9,16

Discussion and Conclusion

Preventive medicine is one of the issues that has a significant place in traditional Persian MEDICINE. Avicenna, in relation to the definition of medicine science, in Canon of Medicine states that the aim of medicine is maintaining well-being or returning it at the time of illness. ¹⁰ Studies of the Canon of Medicine have indicated that Ibn Sina was the first author to discuss the lifestyle factors. He had a clear understanding of the lifestyle factors. He believed that lifestyle should be considered the basis in preventing diseases. ¹⁰ In traditional Persian medicine, prevention and maintaining health is necessarily prior to the treatment. The 6 essential principles, including air, mental movement and Repose, sleep and awakefulness, foods and drinks, excretion of unnecessary substances and retention of necessary substances, and body movement and repose have been described in details in all texts of traditional Persian Medicine. ^6,7 As it has been said earlier, preventive and therapeutic strategies of traditional Persian medicine are not limited to only using medicines; change of lifestyle and nutrition are among the most important strategies for prevention of Alzheimer’s disease. In traditional Persian medicine, change of lifestyle means physical activities, increasing brain exercises, participating in friends’ gatherings and happy parties, regulating sleep, using perfume, smelling flowers, and listening to music. Recent studies have supported most of the mentioned strategies. ¹⁶

Nutrition is one of the most important of the 6 essential principles for maintaining health. Nutrition, in addition to its preventive role, is important for treatment purposes. ¹⁰ Changes in lifestyle for the prevention of Alzheimer’s disease as mentioned in traditional Persian medicine texts provides fields of clinical and complementary studies for researchers.