The Myth of Tithonus: Ageing and Dementia in Ancient Greek Thought

Growing (Physically) Old in Ancient Greece

Firstly, it would be important to note that the Ancient Greeks mostly viewed ageing as a period of physical but not cognitive decline. In the writings of Homer (dated from the 8th or 7th century BC), for example, older characters such as Nestor are described as wise and reliable, despite their physical limitations. Greek mythology also features the figure of Tiresias, a blind seer whose exceptional longevity (and the fact that he was the only person to have lived as both a man and a woman) grants him the gift of wisdom, serving as an oracle-like figure to both gods and mortals. Another example comes from the Republic, arguably the greatest of Plato’s works, ⁴ when the elderly character Cephalus says that “the more the pleasures of the body fade, the greater becomes one’s desire and taste for conversation”.

It is striking that even in the Hippocratic writings, between the 5th and 4th centuries BC, there is little to no mention of mental decline in old age.^5,6 Although Hippocrates mentions several age-related and age-dependent diseases in his Aphorisms (such as catarrhal coughs and apoplexy), there is no mention of cognitive symptoms whatsoever. In other works, like “On the Epidemics” or “Airs, Waters and Places”, symptoms like confusion and incoherency are likely more related to acute febrile illnesses than to degenerative processes related to ageing.

In this scenario, it is expected that the first known accounts of Tithonus do not mention any sort of cognitive or behavioural problems. Between the 7th and the 6th centuries BC, Sappho mentioned Tithonus in her beautiful poem 58, as she laments the physical decline of growing old, but without any mention of cognitive deterioration.

In the translation of M. L. West ⁷ :

“(…) But me – my skin which once was soft is withered now

The First Signs of Dementia in Western Civilisation

The most known mention of the myth of Tithonus, however, comes from the Homeric Hymns to Aphrodite, between the 7th and the 6th centuries BC. Here in the translation by Nagy ⁸ :

“But when hateful old age was pressing hard on him, with all its might,

In this excerpt, we see Tithonus as an elderly individual who was shut in a chamber alone, yet keeps talking to himself. The line “his voice pours out – it never seems to end” has been generally interpreted by scholars as suggesting incoherent and repetitive speech, with translations also using terms like “babbling”. Rather than an old man sharing his wisdom, the depiction of Tithonus can be seen, through a modern lens, as that of a person with dementia speaking compulsively. Curiously, as the myth organically evolved across time, the incessant vocalising of Tithonus became the singing of a cicada. More modern versions of the myth, like that of Ovid in his celebrated “Metamorphosis” (1st century AD), cite this as the mythological origin of this insect.

What is particularly interesting about this passage is that it is probably one of the first mentions of an individual with dementia in the Western world. The Egyptians were probably responsible for the first accounts of dementia in history, as the Instruction of Ptahhotep (ca 2400 BC) refers to difficulties to recall the past as one of the afflictions of extreme old age.^9,10 In contrast, descriptions of older individuals with cognitive decline are extremely rare in Ancient Greece.^6,10 Finley states in an article from 1981 on old age in Classical Greece and Rome, ⁶ that although it is not possible to “conclude that senile dementia was non-existent in antiquity”, he did not know any “way to penetrate the almost total silence”. More recently, Finch and Burstein ¹⁰ noted that the first mentions of age-related cognitive decline in Ancient Greece date from the 6^th century BC, when Solon stated that speech and thought weakened at old age, ¹¹ albeit no account of advanced dementia could be found in Ancient Greek texts.

There are also a few subtle references to age-related cognitive decline in Plato’s and Aristotle’s writings. Around 400 BC, Plato speculated in Timaeus that forgetfulness might arise from bodily imbalances, such as excessive internal flows or disruptions in the soul’s connection to the body. ¹² Later, his pupil Aristotle proposed a more physiological explanation: in On memory he suggests that memory loss and cognitive dulling (morosis) result from the accumulation of cold black bile in the body – a physiological characteristic of old age. ¹³

Of course, there is no way to reliably estimate the prevalence of dementia in Ancient Greece, but the scarcity of references strongly suggests that it was much lower than it is now. First of all, the high frequency of wars and endemic diseases meant that life expectancy was around 20-30 years, probably somewhat higher in rural, mountainous regions. It is estimated that one third of children died before 10 years old and barely 5-8% of the total population reached 60 years old (possibly even less in urban areas). ¹⁴ It is inevitable here to allude to the comment of Seneca upon the woes of a short life-expectancy in his celebrated De Brevitate Vitae ¹⁵ – although centuries later, the concern was still very similar:

The majority of mortals, Paulinus, complain bitterly of the spitefulness of Nature, because we are born for a brief span of life, because even this space that has been granted to us rushes by so speedily and so swiftly that all save a very few find life at an end just when they are getting ready to live.

Another important point is that much of what we now know as modifiable risk factors for dementia – which are related to around 45% of its cases ¹⁶ – were incidentally avoided by the Ancient Greeks. Thus, individuals who survived childhood had a lifestyle that included outdoor activities, practice of sports and social interactions. Moreover, their diet — rich in vegetables, legumes, olive oil, and moderate amounts of fish and wine —resembles what we now call the Mediterranean diet, which is considered protective against dementia. ¹⁷ Another important risk factor for dementia that was virtually absent in Ancient Greece is air pollution, a problem that arose in Rome and that may have contributed to the probable increase of dementia prevalence among the Romans. ¹⁰

Interestingly, however, a lot of the remaining artistic and literary masterpieces we still know from classical times come from aged Greeks: Sophocles and Euripides wrote some of their most important plays after the age of eighty, and Plato completed one of his major works, The Laws, when he was over seventy. ⁶ Finley suggests ⁶ – and we share his view - that this phenomenon is an example of survivor’s bias or, in his words, that these were “ a highly selected assemblage, men who possessed both great luck and great toughness, physiological and psychological, which is no longer the case as the number of over-sixties moves towards twenty percent of the total population”.

The Elderly Greeks and Their Caregivers

One important point to consider when we study the social habits and customs of Ancient Greece is that the evidence relies mostly on literature and mythology, which largely reflect the behaviour of the elite. ⁶ Therefore, the observations that follow apply mainly to the upper strata of society – we have virtually no information about how the rural population or enslaved people dealt with the elderly in that time.

With this in mind, we return to the myth of Tithonus as told in the Homeric Hymn to Aphrodite, where we find a rare glimpse of how the Ancient Greeks cared for the elderly. Again, in the translation by Nagy ⁸ :

“But when the first strands of gray hair started growing

One remarkable aspect of this passage is that it follows a common pattern in Greek literature to portray sexuality among the elderly – as Eos stops seeing Tithonus as a sexual partner. Old individuals were depicted in texts and plays as grotesque, disgusting and sexually unattractive. ¹⁸ Some authors, like the comedian Aristophanes, frequently used harsh humour to mock the sexuality of older women ⁶ ; for example, in his famous play Lysistrata ¹⁹ : “Old women still fancy themselves as full of passion and fire, but their bodies betray them—creaky joints and faded charms.” This ideal of youthful beauty and sexual vigour would be later revived during the European Renaissance, when art and literature once again celebrated young, vigorous, sensual bodies. This imagery survives in our modern society, which still holds similar views about elderly sexuality. The theme, however, remains taboo and is rarely, if ever, openly discussed.

We can also see here the goddess Eos playing the part of the caregiver of an elderly person. In Ancient Greece, most of the care for elderly individuals was performed by their own family – formal or institutional care networks were virtually nonexistent, with only rare exceptions in later periods or specific contexts. While the sons were usually deemed responsible for the financial and material sustenance of their elderly parents, daily care was, as still occurs today, mostly reserved for women (wives, daughters or other female relatives).^6,20 The female role of caregiving is, for example, mentioned by Xenophon in Oeconomicus, a Socratic dialogue on household management ²¹ :

“There is just one of all these occupations which devolve upon you” (he is referring to his wife), I added, “you may not find so altogether pleasing. Should any one of our household fall sick, it will be your care to see and tend them to the recovery of their health”.

It is remarkable in the myth of Tithonus that, even though the female relative is a goddess, we still see her as an informal caregiver – a symbolic reflection of how entrenched gender roles were in Ancient Greek society, transcending even divine narratives.

When we discuss care for elderly individuals – and particularly those with dementia – it is impossible to overlook the issue of caregiver burden. Unfortunately, we have very little evidence of this in Ancient Greek literature. The lack of mentions may partly stem from how they saw caregiving as strongly connected to piety and justice – values deeply embedded in the Greek culture. A rare glimpse of these values can be found in “Works and Days”, ²² a famous poem by Hesiod, one of the most important authors of classic literature. In this passage, concerns about the treatment of ageing parents are directly linked to divine justice, as seen in the following excerpt:

“Once men grow old, their sons will give

They will reproach their parents, shouting at them with harsh words.

Wretches! Men who do not know about the

In the myth of Tithonus, we do not have any direct depiction of caregiver burden – if feeling distressed while caregiving was considered impious or unjust, it would be unimaginable to portray a goddess in such a way. It is, however, reasonable to see the signs of burden in the passage “(…) when hateful old age was pressing hard on him, (…) she put him in her chamber, and she closed the shining doors over him”.