The Use Of Honey As A Natural Preventive Therapy of Cognitive Decline And Dementia In Iraq
University of Babylon, College of Medicine
Honey is one nature's most splendid gifts to mankind. It posses unique nutritional and medicinal properties. Honey is old as written history and it was used to treat amnesia. A randomized, placebo controlled, double blind,5 year study with 2290 cognitvely intact subjects and 603 with a mild cognitive impairment (total 2893 ,aged 65 and older),randomized to one daily tablespoon of honey or placebo. Honey was given to 1493 subjects, while only1400 received placebo. Dementia assessment was done every 6 months. This study was conducted in Iraq from Nov.2003 to Nov. 2008.As a total, only 489 subjects developed dementia. It was seen in 394 of those receiving placebo and only in 95 subjects receiving honey(P-value <0.05).
Honey and it's properties is considered one of the natural preventive therapies of both cognitive decline and dementia. It has antioxidant properties and it enhances the brain's cholinergic system and circulation. Further studies are needed to investigate the role of honey in slowing the progression of dementia and if it has any antiamyloid properties.
يمتلك العسل خاصية غذائية وخاصية طبية في نفس الوقت ويعود تاريخه الى زمن السومريين والاكديين كما وقد ذكر في القرآن الكريم , تمت هذه الدراسة على مدى خمسة سنوات في العراق اذ كان مجموع العينة التي اُخذت 2893 وتتراوح اعمارهم من 65 سنة فما فوق وكان 2290 منهم ذات قابلية ذهنية طبيعية والمتبقي (603) هم في مرحلة انتقالية ما بين الطبيعي ومرض الخرف . لقد اُعطي العسل بمقدار ملعقة طعام يومياً لـ 1493 شخص من العينة الكلية والمتبقي (1400) شخص اُعطوا عقار معين وكانت تجرى الفحوصات السريرية لهؤلاء المجموعتين كل ستة أشهر وكانت النتيجة انه 489 اصيبوا بمرض الخرف (95 فقط منهم ممن كانوا يتناولون العسل والمتبقي منهم 394 ممن كانوا يتناولون العقار الطبي المعين ) ومن هذه الدراسة نرى ان العسل وخصائصه الطبية يعتبر علاج طبيعي وقائي ضد مرض الخرف وضد التدهور التدريجي للذاكرة اذا يمتلك خصائص ضد التأكسد ويقوي الدورة الدموية للدماغ لذا ننصح بتناول العسل يوميا لجميع فئات المجتمع .
Honey is one of nature's most splendid gifts to mankind. It possess unique nutritional and medicinal properties. The word honey is derived from the Arabic Han. This became Honing in German and Huning in old English. The word is used in English language as a term of endearment.
Honey is a viscid, accharine substance, semitranslucent and light yellow-brown colour, with an aromatic odour and a sweet taste. After times, it becomes opaque and crystalline. Most of us know honey as a sweet ,golden liquid. But, infact ,honey can be found in a variety of forms.
Honey is old as written history, dating back to the Sumerians(3100 B.C.) and the Akkadians (2400 B.C.).It was mentioned in the cuneiform writings and in the Hittite Code(1350 B.C.).According to the Iraqi references(Al-Jade, 1968; Al-Ahmed, 1974; Al-Baderi, 1975),the Sumerians, the Akkadians and the Assyrians used it to treat amnesia in the elderly people. It was given to the Kings in Ancient Mesopotamia offering them a longer life(Al-Jade, 1968; Al-Ahmed, 1974; Al-Baderi, 1975).
In 1989, an editorial in the Journal of the Royal Society of Medicine (Zumla, 1989) expressed the opinion" The therapeutic potential of uncontaminated ,pure honey is grossly underutilized. It is widely available in most of the communities and although the mechanism of action of several of it's properties remain obscure and needs further investigation, the time has come now for conventional medicine to lift the blinds off this traditional remedy and give it it's due recognition".
Selection of the study subjects: A total of 2893 subjects ,aged 65 and older were recruited in this study at both Baghdad and Babylon Teaching Hospitals of Iraq from Nov.2003-Nov.2008.Iraq or Mesopotomia (Al-Himyari-2007) is considered the heart of the middle east. It's population is 27,499,638 (2007 estimate).Iraq is comprised of four main geographical regions. First is the desert in the west southwest area of the country. Second is the rolling upland between the upper Tigris and Euphrates rivers (known as Al-Jazera).Third, the highlands in the north northeast region of the country. Finally the Alluvial plain through which the Tigris and the Euphrates rivers flow. The climate of Iraq is overwhelmingly characterized by desert or desert like arid conditions.
For this study we identified subjects using the following inclusion criteria: No dementia diagnosis at baseline and valid cognitive testing at baseline to allow diagnosis of Mild Cognitive Impairment (MCI).Exclusion criteria were mental retardation, known brain cancer ,parkinson's disease, severe weakness or severe sensory impairment leading to invalid cognitive testing and depression. Those with MCI were defined as those with cognitive decline ,not normal for age not demented and essentially normal functional activities according to the Diagnostic and Statistical Manual of Mental Dissorders, Revised Third Edition Criteria(American Psychiatric Association-1987) ) for Dementia.
Characteristics of all study groups
Characteristics of all study groups
< 12 years
72 ± 6.81
78.76 ± 6.8
At each assessment which was done every 6 months, the participants were interviewed at the hospital, at their homes and by telephone interview (Brandt et al., 1988,Welsh et al., 1993, Plassman, 1994). 75% of the participants were interviewed at home and hospital. The main instrument used was SIDAM(Structured Interview for Diagnosis of Dementia of Alzheimer type, Multi-Infarct Dementia and Dementia of other Etiology according to ICD-10 and DSM-I)( Zaudig , 1991 ).
Statistical analysis was done using the Chi square and testing of 2 population proportions (Wayne ,1998 ).
In this double blind, placebo controlled, 5 year study, the patients (2290 cognitively intact subjects and 603 with MCI) are randomized to one daily tablespoon of honey or placebo .Honey was given to 1493 subjects, while only 1400 received placebo.
Of the 2893 subjects, only 489 developed dementia (235 had a previous MCI).It was seen in 394 of those receiving placebo and only in 95 subjects receiving honey (p–value< 0.05).Dementia diagnosis was seen in those with less than 12 years education years (345 subjects).Weight gain was seen in 73 subjects only and their body mass index was between 27-30.
In a community-based cohort of 2893 individuals, we found that those taking honey were less liable to develop dementia (P<0.05) than those taking placebo. Although several studies have examined the relative risk of dementia among persons with MCI and comparable individuals without cognitive impairment (Bennett, 2002; Larrieu, 2002; Fisk, 2003; Boyle, 2006),persons with MCI had markedly lower baseline scores and declined considerably more rapidly each year on a measure of global cognitive function than those without cognitive impairment.
The test part of SIDAM consisted of 55 items, including all 30 items of the Mini-Mental State Examination(MMSE).The test covers six areas of neuropsycological function:1-Orientation,assessing the orientation of the time, place and person; 2-memory,measured by delayed verbal recall of a word list and a fictitious name and address, delayed visual reproduction, questions on biographical knowledge and on historical data unrelated to a person's life;3-intellectual abilities, assessed by items of abstract thinking (differences, explaining the meaning of idiomatic expressions), and judgement (describing pictures representing actions, and plausibilityjudgement); 4-verbal abilities and calculation, assessed by calculating serial sevens, spelling backward, and backward digit span;5-constructional abilities (visual-spatial), assessed by coping figures; and 6-aphasia and apraxia ,assessed by naming objects, reading and obeying a sentence, writing a sentence, and performing a three-stage command.
This study revealed dementia diagnosis (345 out of 489)was more in individuals with education years less than 12 years. This highlightens how education plays a role in delaying or accelerating the progression of dementia.
One might ask ,why did we use honey in our study? The answer is because our ancestors used it to treat amnesia and it's use is also recommended in the Holy Koran "There issues from within their bodies(bees),a drink of varying colours, wherein is healing for men" . We conclude that honey and it's properties is considered one of the natural preventive therapies of both cognitive decline and dementia. It has antioxidant properties and it enhances the brain's cholinergic system and circulation. Further studies are needed to investigate the role of honey in slowing the progression of dementia and if it has any antiamyloid properties.
Al-Ahmed (1974). The Ancient Iraqi Medicine, Sumer J.,vol.30-Baghdad;(94-98).
Al-Baderi (1975). Series of Al-Baderi of History of Iraq- Baghdad; (1-28).
Al-Himyari F. (2007). Epilepsy in Mesopotamia 3100-539 B.C. Neurology;68 Supplement-1: A7.Abstract.
Al-Jader, (1968). The Babylonian-Assyrian Medicine-Sumer J.,Vol.1-Baghdad;(191-206).
American Psychiatric Association. Diagnostic and Statistical manual of mental disorders, third edition-revised. Washington DC: American Psychiatric Association, 1987.
Bennett DA Wlison RS, Schneider JA, et al. (2002). Natural history of mild cognitive impairment in older persons. Neurology ;59;198-205.
Boyle PA, Wilson R.S., Aggarwal N.T., Tang Y., (2006). Mild Cognitive Impairment. Risk of Alzheimer disease and rate of cognitive decline. Neurology; 441-445.
Brandt J, Spencer M, Folstein M. (1988). The telephone interview for cognitive status. Neuropsychiatry Neuropsychol Behav. Neurol ;111-117.
Fisk JD, Merry HR, Rockwood K. (2003). Variations in case definition affect prevalence but not outcomes of mild cognitive impairment. Neurology; 61 :1179-1184.
Larrieu S, Letenneur L ,Orgogozo JM, et al. (2002). Incidence and outcome of mild cognitive impairment in a population-based prospective cohort. Neurology; 59:1594-1599.
Plassman Bl, Newmann TT, Welsh KA, Helms M, Breitner JCS. (1994). Properties of Telephone interview for cognitive status. Application in epidemiological and longitudinal studies. Neuropsychiatry Neuropsychol Behav Neurol , 7:235-241.
Wayne W. Daniel. Biostatistics (1998). A foundation for analysis in the health sciences (7th ed.)U.S. edition: John Wiley and Sons, Inc.
Welsh KA, Breitner JCS, Magruder-Habib KM. (1993). Detection of dementia in the elderly using telephone screening of cognitive status. Neuropsychiatry Neuropsychol Behav Neurol ;6 103-110.
Zaudig M, Mittelhammer J, Hiller W, et al. SIDAM: (199). A structured interview for the diagnosis of dementia of Alzheimer type, multiinfarct dementia and dementia of other aetiology according to ICD-10 and DSM-111-R.Psychol Med; 21 : 225-236.
Zumla A, Lulat A.(1989). A remedy redisdovered. JR Soc.Med.;82:384-85.