What You Can Do to Prevent Alzheimer's | Lisa Genova | TED

3,268,857 views ใƒป 2017-05-19

TED


ืื ื ืœื—ืฅ ืคืขืžื™ื™ื ืขืœ ื”ื›ืชื•ื‘ื™ื•ืช ื‘ืื ื’ืœื™ืช ืœืžื˜ื” ื›ื“ื™ ืœื”ืคืขื™ืœ ืืช ื”ืกืจื˜ื•ืŸ.

ืžืชืจื’ื: Zeeva Livshitz ืžื‘ืงืจ: Ido Dekkers
00:12
How many people here would like to live to be at least 80 years old?
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ื›ืžื” ืื ืฉื™ื ื›ืืŸ ืจื•ืฆื™ื ืœื—ื™ื•ืช ืœืคื—ื•ืช ืขื“ ื’ื™ืœ 80?
00:17
Yeah.
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ื›ืŸ.
00:19
I think we all have this hopeful expectation
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ืื ื™ ื—ื•ืฉื‘ืช ืฉืจื•ื‘ื ื• ืžืฆืคื™ื ื‘ืชืงื•ื•ื”
00:22
of living into old age.
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ืœื—ื™ื•ืช ืขื“ ื’ื™ืœ ื–ืงื ื”.
00:24
Let's project out into the future,
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ื‘ื•ืื• ื•ื ื“ืžื™ื™ืŸ ืืช ื”ืขืชื™ื“,
00:26
to your future "you's,"
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ื”ืขืชื™ื“ ืฉื”ื•ื "ืืชื,"
00:28
and let's imagine that we're all 85.
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ื•ื ื“ืžื™ื™ืŸ ืฉื›ื•ืœื ื• ื‘ื ื™ 85.
00:31
Now, everyone look at two people.
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ื›ืขืช, ื›ื•ืœื ื™ืกืชื›ืœื• ืขืœ ืฉื ื™ ืื ืฉื™ื.
00:34
One of you probably has Alzheimer's disease.
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ืœืื—ื“ ืžื›ื ื›ื ืจืื” ื™ืฉ ืžื—ืœืช ืืœืฆื”ื™ื™ืžืจ.
00:39
(Laughter)
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(ืฆื—ื•ืง)
00:42
Alright, alright.
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ื‘ืกื“ืจ ื‘ืกื“ืจ.
00:44
And maybe you're thinking, "Well, it won't be me."
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ื•ืื•ืœื™ ืืชื ื—ื•ืฉื‘ื™ื, "ื˜ื•ื‘, ื–ื” ืœื ื™ื”ื™ื” ืื ื™".
00:49
Then, OK. You are a caregiver.
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ืื– ื‘ืกื“ืจ. ืืชื ื”ืžื˜ืคืœื™ื.
00:53
So --
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ืื– --
00:54
(Laughter)
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(ืฆื—ื•ืง)
00:57
so in some way,
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ืื– ื‘ื“ืจืš ื›ืœืฉื”ื™,
00:58
this terrifying disease is likely to affect us all.
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ืžื—ืœื” ืžืคื—ื™ื“ื” ื–ื• ืขืฉื•ื™ื” ืœื”ืฉืคื™ืข ืขืœ ื›ื•ืœื ื•.
01:02
Part of the fear around Alzheimer's stems from the sense
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ื—ืœืง ืžื”ืคื—ื“ ืกื‘ื™ื‘ ืืœืฆื”ื™ื™ืžืจ ื ื•ื‘ืข ืžื”ืชื—ื•ืฉื”
01:05
that there's nothing we can do about it.
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ืฉืื™ืŸ ืฉื•ื ื“ื‘ืจ ืฉืื ื—ื ื• ื™ื›ื•ืœื™ื ืœืขืฉื•ืช ื‘ืงืฉืจ ืœื–ื”.
01:08
Despite decades of research, we still have no disease-modifying treatment
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ืœืžืจื•ืช ืขืฉืจื•ืช ืฉื ื™ื ืฉืœ ืžื—ืงืจ, ืขื“ื™ื™ืŸ ืื™ืŸ ืœื ื• ื˜ื™ืคื•ืœ ืœืžื™ืชื•ืŸ ื”ืžื—ืœื”
01:13
and no cure.
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ื•ืœื ืจื™ืคื•ื™.
01:15
So if we're lucky enough to live long enough,
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ืื– ืื ื™ืชืžื–ืœ ืžื–ืœื ื• ืœื—ื™ื•ืช ืžืกืคื™ืง ื–ืžืŸ,
01:17
Alzheimer's appears to be our brain's destiny.
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ืžื—ืœืช ื”ืืœืฆื”ื™ื™ืžืจ ืชื”ื™ื” ื’ื•ืจืœื• ืฉืœ ื”ืžื•ื— ืฉืœื ื•.
01:21
But maybe it doesn't have to be.
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ืื‘ืœ ืื•ืœื™ ื–ื” ืœื ื—ื™ื™ื‘ ืœื”ื™ื•ืช.
01:23
What if I told you we could change these statistics,
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ืžื” ืœื• ืืžืจืชื™ ืœื›ื ืฉื ื•ื›ืœ ืœืฉื ื•ืช ื ืชื•ื ื™ื ืกื˜ื˜ื™ืกื˜ื™ื™ื ืืœื”,
01:26
literally change our brain's destiny,
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ืคืฉื•ื˜ ืœืฉื ื•ืช ืืช ื’ื•ืจืœื• ืฉืœ ื”ืžื•ื— ืฉืœื ื•,
01:29
without relying on a cure or advancements in medicine?
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ืžื‘ืœื™ ืœื”ืกืชืžืš ืขืœ ืชืจื•ืคื”, ืื• ืขืœ ื”ืชืงื“ืžื•ืช ื‘ืจืคื•ืื”?
01:33
Let's begin by looking at what we currently understand
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ื‘ื•ืื• ื ืชื—ื™ืœ ื‘ื”ืชื‘ื•ื ื ื•ืช ืขืœ ืžื” ืฉืื ื—ื ื• ืžื‘ื™ื ื™ื ื›ืจื’ืข
01:36
about the neuroscience of Alzheimer's.
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ืขืœ ืžื“ืข ื”ืžื•ื— ืฉืœ ื”ืืœืฆื”ื™ื™ืžืจ.
01:39
Here's a picture of two neurons connecting.
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ื”ื ื” ืชืžื•ื ื” ืฉืœ ืฉื ื™ ื ื•ื™ืจื•ื ื™ื ืžืชื—ื‘ืจื™ื.
01:42
The point of connection, this space circled in red,
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ื ืงื•ื“ืช ื”ื—ื™ื‘ื•ืจ, ื”ืฉื˜ื— ืฉืžื•ืงืฃ ื‘ืื“ื•ื,
01:45
is called the synapse.
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ื•ื ืงืจื ืกื™ื ืคืกื”.
01:47
The synapse is where neurotransmitters are released.
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ื”ืกื™ื ืคืกื” ื”ื™ื ื”ื™ื›ืŸ ืฉื ื•ื™ืจื•ื˜ืจื ืกืžื™ื˜ื•ืจื™ื ืžืฉืชื—ืจืจื™ื.
01:50
This is where signals are transmitted, where communication happens.
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ื–ื” ื”ืžืงื•ื ืฉื‘ื• ื”ืื•ืชื•ืช ืžื•ืขื‘ืจื™ื, ืฉื‘ื• ืžืชืจื—ืฉืช ืชืงืฉื•ืจืช.
01:55
This is where we think, feel, see, hear, desire ...
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ื–ื” ื”ืžืงื•ื ื‘ื• ืื ื• ื—ื•ืฉื‘ื™ื, ืžืจื’ื™ืฉื™ื ืจื•ืื™ื, ืฉื•ืžืขื™ื, ืžืฉืชื•ืงืงื™ื ...
02:00
and remember.
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ื•ื–ื•ื›ืจื™ื.
02:01
And the synapse is where Alzheimer's happens.
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ื•ื”ืกื™ื ืคืกื” ื–ื” ื”ืžืงื•ื ื‘ื• ื”ืืœืฆื”ื™ื™ืžืจ ืงื•ืจื”.
02:04
Let's zoom in on the synapse
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ื‘ื•ืื• ื•ื ืชืžืงื“ ืขืœ ื”ืกื™ื ืคืกื”
02:06
and look at a cartoon representation of what's going on.
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ื•ื ืกืชื›ืœ ืขืœ ืงืจื™ืงื˜ื•ืจื” ืฉืžื™ื™ืฆื’ืช ืืช ืžื” ืฉืงื•ืจื”.
02:10
During the business of communicating information,
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ื‘ืžื”ืœืš ื”ืขืกืงื” ืฉืœ ื”ืขื‘ืจืช ืžื™ื“ืข,
02:12
in addition to releasing neurotransmitters like glutamate into the synapse,
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ื‘ื ื•ืกืฃ ืœืฉื—ืจื•ืจ ื ื•ื™ืจื•ื˜ืจื ืกืžื™ื˜ืจื™ื ื›ืžื• ื’ืœื•ื˜ืžื˜ ืœืชื•ืš ื”ืกื™ื ืคืกื”,
02:16
neurons also release a small peptide called amyloid beta.
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ื ื•ื™ืจื•ื ื™ื ื’ื ืžืฉื—ืจืจื™ื ืคืคื˜ื™ื“ ืงื˜ืŸ ืฉื ืงืจื ืขืžื™ืœื•ืื™ื“-ื‘ื˜ื.
02:22
Normally, amyloid beta is cleared away metabolized by microglia,
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ื‘ื“ืจืš ื›ืœืœ, ืขืžื™ืœื•ืื™ื“-ื‘ื˜ื ืžืกื•ืœืง ื‘ืขื–ืจืช ืžื˜ื‘ื•ืœื™ื–ื ืฉืœ ื”ืžื™ืงืจื•ื’ืœื™ื™ื”,
02:27
the janitor cells of our brains.
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ืฉืจืช ื”ื ืงื™ื•ืŸ ืฉืœ ื”ืžื•ื— ืฉืœื ื•.
02:30
While the molecular causes of Alzheimer's are still debated,
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ื‘ืขื•ื“ ื”ื’ื•ืจืžื™ื ื”ืžื•ืœืงื•ืœืจื™ื™ื ืฉืœ ื”ืืœืฆื”ื™ื™ืžืจ ืขื“ื™ื™ืŸ ื ืชื•ื ื™ื ืœื•ื•ื™ื›ื•ื—,
02:34
most neuroscientists believe that the disease begins
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ืจื•ื‘ ืžื“ืขื ื™ ื”ืžื•ื— ืžืืžื™ื ื™ื ืฉื”ืžื—ืœื” ืžืชื—ื™ืœื”
02:37
when amyloid beta begins to accumulate.
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ื›ืืฉืจ ื”ืขืžื™ืœื•ืื™ื“-ื‘ื˜ื ืžืชื—ื™ืœ ืœื”ืฆื˜ื‘ืจ.
02:40
Too much is released, or not enough is cleared away,
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ื™ื•ืชืจ ืžื“ื™ ืžืฉืชื—ืจืจ, ืื• ืœื ืžืกืคื™ืง ืžืคื•ื ื” ืžืฉื,
02:43
and the synapse begins to pile up with amyloid beta.
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ื•ื”ืกื™ื ืคืกื” ืžืชื—ื™ืœื” ืœื”ืขืจื ืขื ืขืžื™ืœื•ืื™ื“-ื‘ื˜ื.
02:46
And when this happens, it binds to itself,
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ื•ื›ืืฉืจ ื–ื” ืงื•ืจื”, ื”ื•ื ื ืงืฉืจ ืœืขืฆืžื•,
02:49
forming sticky aggregates called amyloid plaques.
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ื•ื™ื•ืฆืจ ืชืœื›ื™ื“ื™ื ื“ื‘ื™ืงื™ื ืฉื ืงืจืื™ื ืจื‘ื“ื™ ืขืžื™ืœื•ืื™ื“.
02:53
How many people here are 40 years old or older?
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ื›ืžื” ืื ืฉื™ื ื›ืืŸ ื”ื ื‘ื ื™ 40 ื•ืžืขืœื”?
02:57
You're afraid to admit it now.
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ืืชื ืคื•ื—ื“ื™ื ืœื”ื•ื“ื•ืช ื‘ื–ื” ืขื›ืฉื™ื•.
02:59
This initial step into the disease,
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ืืช ื”ืฆืขื“ ื”ืจืืฉื•ื ื™ ื”ื–ื” ืœืชื•ืš ื”ืžื—ืœื”,
03:01
this presence of amyloid plaques accumulating,
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ื ื•ื›ื—ื•ืช ื–ื• ืฉืœ ืจื‘ื“ื™ ืขืžื™ืœื•ืื™ื“ ืžืฆื˜ื‘ืจื™ื,
03:04
can already be found in your brains.
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ื ื™ืชืŸ ื›ื‘ืจ ืœืžืฆื•ื ื‘ืžื•ื— ืฉืœื›ื.
03:08
The only way we could be sure of this would be through a PET scan,
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ื ื•ื›ืœ ืœื”ื™ื•ืช ื‘ื˜ื•ื—ื™ื ื‘ื›ืš ืจืง ื‘ืืžืฆืขื•ืช ื˜ื•ืžื•ื’ืจืคื™ื™ืช ืคืœื™ื˜ืช ืคื•ื–ื™ื˜ืจื•ื ื™ื,
03:11
because at this point, you are blissfully unaware.
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ื›ื™ ื‘ืฉืœื‘ ื–ื” ืœืžืจื‘ื” ื”ืžื–ืœ, ืื™ื ื›ื ืžื•ื“ืขื™ื,
03:15
You're not showing any impairments in memory, language, or cognition ...
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ืื™ื ื›ื ืžืจืื” ืคื’ืžื™ื ื›ืœืฉื”ื ื‘ื–ื™ื›ืจื•ืŸ, ื‘ืฉืคื” ืื• ื‘ืงื•ื’ื ื™ืฆื™ื” .
03:19
yet.
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ืขื“ื™ื™ืŸ.
03:21
We think it takes at least 15 to 20 years of amyloid plaque accumulation
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ืื ื• ื—ื•ืฉื‘ื™ื ืฉื–ื” ืœื•ืงื— ืœืคื—ื•ืช 15 ืขื“ 20 ืฉื ื™ื ืฉืœ ื”ืฆื˜ื‘ืจื•ืช ืจื•ื‘ื“ ืขืžื™ืœื•ืื™ื“
03:25
before it reaches a tipping point,
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ืœืคื ื™ ืฉื–ื” ืžื’ื™ืข ืœื ืงื•ื“ืช ืžืคื ื”,
03:28
then triggering a molecular cascade
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ื•ืื– ืžืคืขื™ืœ ืžืคืœ ืžื•ืœืงื•ืœืจื™
03:30
that causes the clinical symptoms of the disease.
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ืฉื’ื•ืจื ืœืชืกืžื™ื ื™ื ื”ืงืœื™ื ื™ื™ื ืฉืœ ื”ืžื—ืœื”.
03:33
Prior to the tipping point,
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ืœืคื ื™ ื ืงื•ื“ืช ื”ืžืคื ื”,
03:35
your lapses in memory might include things like,
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ื”ื›ืฉืœื™ื ื‘ื–ื™ื›ืจื•ืŸ ืขืฉื•ื™ื™ื ืœื›ืœื•ืœ ื“ื‘ืจื™ื ื›ืžื•,
03:39
"Why did I come in this room?"
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"ืœืžื” ื‘ืืชื™ ืœื—ื“ืจ ื”ื–ื”?"
03:41
or "Oh ... what's his name?"
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ืื• "ืื•ื™ ... ืžื” ืฉืžื•?"
03:44
or "Where did I put my keys?"
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ืื• "ืื™ืคื” ืฉืžืชื™ ืืช ื”ืžืคืชื—ื•ืช ืฉืœื™?"
03:47
Now, before you all start freaking out again,
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ืขื›ืฉื™ื•, ืœืคื ื™ ืฉืืชื ืžืชื—ื™ืœื™ื ืฉื•ื‘ ืœื”ื™ื•ืช ืžื•ื˜ืจืคื™ื,
03:49
because I know half of you did at least one of those in the last 24 hours --
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ื›ื™ ืื ื™ ื™ื•ื“ืขืช ืฉื—ืฆื™ ืžื›ื ืขืฉื• ืœืคื—ื•ืช ืื—ื“ ืžืืœื” ื‘ -24 ื”ืฉืขื•ืช ื”ืื—ืจื•ื ื•ืช -
03:55
these are all normal kinds of forgetting.
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ื›ืœ ืืœื” ื”ื ืกื•ื’ื™ื ื ื•ืจืžืœื™ื™ื ืฉืœ ืฉื›ื—ื”.
03:58
In fact, I would argue that these examples
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ืœืžืขืฉื”, ื”ื™ื™ืชื™ ื˜ื•ืขื ืช ืฉื“ื•ื’ืžืื•ืช ืืœื•
04:00
might not even involve your memory,
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ืื•ืœื™ ืืคื™ืœื• ืœื ืžืขืจื‘ื•ืช ืืช ื”ื–ื™ื›ืจื•ืŸ ืฉืœื›ื,
04:02
because you didn't pay attention to where you put your keys
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ื›ื™ ืœื ืฉืžืชื ืœื‘ ื”ื™ื›ืŸ ืืชื” ืžื ื™ื—ื™ื ืืช ื”ืžืคืชื—ื•ืช ืฉืœื›ื
04:05
in the first place.
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ืžืœื›ืชื—ื™ืœื”.
04:07
After the tipping point,
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ืœืื—ืจ ื ืงื•ื“ืช ื”ืžืคื ื”,
04:08
the glitches in memory, language and cognition are different.
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ื”ืชืงืœื•ืช ื‘ื–ื™ื›ืจื•ืŸ, ื‘ืฉืคื” ื•ื‘ืงื•ื’ื ื™ืฆื™ื” ื”ืŸ ืฉื•ื ื•ืช.
04:12
Instead of eventually finding your keys in your coat pocket
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ื‘ืžืงื•ื ืœืžืฆื•ื ื‘ืกื•ืคื• ืฉืœ ื“ื‘ืจ ืืช ื”ืžืคืชื—ื•ืช ื‘ื›ื™ืก ื”ืžืขื™ืœ ืฉืœื›ื
04:15
or on the table by the door,
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ืื• ืขืœ ื”ืฉื•ืœื—ืŸ ืœื™ื“ ื”ื“ืœืช,
04:17
you find them in the refrigerator,
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ืืชื ืžื•ืฆืื™ื ืื•ืชื ื‘ืžืงืจืจ,
04:20
or you find them and you think,
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ืื• ืฉืืชื ืžื•ืฆืื™ื ืื•ืชื ื•ื—ื•ืฉื‘ื™ื,
04:22
"What are these for?"
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"ื‘ืฉื‘ื™ืœ ืžื” ืืœื”?"
04:24
So what happens when amyloid plaques accumulate to this tipping point?
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ืื– ืžื” ืงื•ืจื” ื›ืืฉืจ ืจื‘ื“ื™ ืขืžื™ืœื•ืื™ื“ ืžืฆื˜ื‘ืจื™ื ืœื ืงื•ื“ืช ื”ืžืคื ื” ื”ื–ืืช?
04:29
Our microglia janitor cells become hyper-activated,
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ืชืื™ ืฉืจืช ื”ืžื™ืงืจื•ื’ืœื™ื™ื” ืฉืœื ื• ื”ื•ืคื›ื™ื ื”ื™ืคืจ-ืคืขื™ืœื™ื,
04:33
releasing chemicals that cause inflammation and cellular damage.
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ืžืฉื—ืจืจื™ื ื›ื™ืžื™ืงืœื™ื ืฉื’ื•ืจืžื™ื ืœื“ืœืงืช ื•ืœื ื–ืง ืชืื™.
04:37
We think they might actually start clearing away
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ืื ื—ื ื• ื—ื•ืฉื‘ื™ื ืฉื”ื ืขืฉื•ื™ื™ื ืœืžืขืฉื” ืœื”ืชื—ื™ืœ ืœืกืœืง
04:40
the synapses themselves.
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ืืช ื”ืกื™ื ืคืกื•ืช ืขืฆืžืŸ.
04:42
A crucial neural transport protein called "tau" becomes hyperphosphorylated
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ื—ืœื‘ื•ืŸ ืชื—ื‘ื•ืจื” ืขืฆื‘ื™ ื—ื™ื•ื ื™ ื”ืžื›ื•ื ื” "ื˜ืื•" ื ืขืฉื” ื”ื™ืคืจ-ืžื–ื•ืจื—ืŸ
04:46
and twists itself into something called "tangles,"
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ื•ืžืชืคืชืœ ืœืžืฉื”ื• ืฉื ืงืจื "ืกื‘ื›ื™ื,"
04:49
which choke off the neurons from the inside.
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ืฉื—ื•ื ืงื™ื ืืช ื”ื ื•ื™ืจื•ื ื™ื ืžื‘ืคื ื™ื.
04:52
By mid-stage Alzheimer's, we have massive inflammation and tangles
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ื‘ืืœืฆื”ื™ื™ืžืจ, ืฉื‘ืฉืœื‘ ื”ื‘ื™ื ื™ื™ื ื™ืฉ ืœื ื• ื“ืœืงืช ืžืกื™ื‘ื™ืช ื•ืกื‘ื›ื™ื
04:56
and all-out war at the synapse
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ื•ืžืœื—ืžืช ื—ื•ืจืžื” ื‘ืกื™ื ืคืกื”
04:58
and cell death.
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ื•ืžื•ื•ืช ืฉืœ ืชืื™ื.
05:00
So if you were a scientist trying to cure this disease,
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ืื– ืื ื”ื™ื™ืชื ืžื“ืขื ื™ื ืฉืžื ืกื™ื ืœืจืคื ืืช ื”ืžื—ืœื”,
05:03
at what point would you ideally want to intervene?
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ื‘ืื™ื–ื• ื ืงื•ื“ื” ื”ื™ื™ืชื ืžืขื“ื™ืคื™ื ืœื”ืชืขืจื‘?
05:06
Many scientists are betting big on the simplest solution:
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ืžื“ืขื ื™ื ืจื‘ื™ื ืžื”ืžืจื™ื ื‘ื’ื“ื•ืœ ืขืœ ื”ืคืชืจื•ืŸ ื”ืคืฉื•ื˜ ื‘ื™ื•ืชืจ:
05:10
keep amyloid plaques from reaching that tipping point,
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ืœืฉืžื•ืจ ืขืœ ืจื‘ื“ื™ ื”ืขืžื™ืœื•ืื™ื“ ืžืœื”ื’ื™ืข ืœื ืงื•ื“ืช ื”ืžืคื ื” ื”ื–ืืช,
05:14
which means that drug discovery is largely focused on developing a compound
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ื›ืœื•ืžืจ ืฉืžืฆื™ืืช ืชืจื•ืคื” ืžืžื•ืงื“ืช ื‘ืžื™ื“ื” ืจื‘ื” ื‘ืคื™ืชื•ื— ืชืจื›ื•ื‘ืช
05:18
that will prevent, eliminate, or reduce amyloid plaque accumulation.
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ืฉืชืžื ืข, ืชื—ืกืœ, ืื• ืชืคื—ื™ืช ื”ืฆื˜ื‘ืจื•ืช ืจื•ื‘ื“ ืขืžื™ืœื•ืื™ื“ื™.
05:24
So the cure for Alzheimer's will likely be a preventative medicine.
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ืื– ืชืจื•ืคื” ืœืืœืฆื”ื™ื™ืžืจ ืฆืคื•ื™ื” ืœื”ื™ื•ืช ืจืคื•ืื” ืžื•ื ืขืช.
05:29
We're going to have to take this pill before we reach that tipping point,
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ื ืฆื˜ืจืš ืœืงื—ืช ืืช ื”ื’ืœื•ืœื” ื”ื–ืืช ืœืคื ื™ ืฉื ื’ื™ืข ืœื ืงื•ื“ืช ื”ืžืคื ื” ื”ื–ืืช,
05:33
before the cascade is triggered,
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ืœืคื ื™ ืฉื”ืžืคืœ ืžื•ืชื ืข.
05:35
before we start leaving our keys in the refrigerator.
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ืœืคื ื™ ืฉืื ื—ื ื• ืžืชื—ื™ืœื™ื ืœื”ืฉืื™ืจ ืืช ื”ืžืคืชื—ื•ืช ืฉืœื ื• ื‘ืžืงืจืจ.
05:39
We think this is why, to date, these kinds of drugs have failed
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ืื ื—ื ื• ื—ื•ืฉื‘ื™ื ืฉื–ื• ื”ืกื™ื‘ื”, ืฉืกื•ื’ื™ื ืืœื” ืฉืœ ืชืจื•ืคื•ืช ื ื›ืฉืœื• ืขื“ ื›ื”,
05:42
in clinical trials --
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ื‘ื ื™ืกื•ื™ื™ื ืงืœื™ื ื™ื™ื -
05:44
not because the science wasn't sound,
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ืœื ื‘ื’ืœืœ ืฉื”ืžื“ืข ืœื ื”ื™ื” ืžื‘ื•ืกืก,
05:46
but because the people in these trials were already symptomatic.
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ืืœื ื‘ื’ืœืœ ืฉื”ืื ืฉื™ื ื‘ื ื™ืกื•ื™ื™ื ื”ืืœื” ื›ื‘ืจ ื”ื™ื• ื‘ืขืœื™ ืชืกืžื™ื ื™ื.
05:50
It was too late.
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ื–ื” ื”ื™ื” ืžืื•ื—ืจ ืžื“ื™.
05:52
Think of amyloid plaques as a lit match.
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ื—ื™ืฉื‘ื• ืขืœ ืจื‘ื“ื™ ืขืžื™ืœื•ืื™ื“ ื›ืขืœ ื’ืคืจื•ืจ ื“ื•ืœืง.
05:55
At the tipping point, the match sets fire to the forest.
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ื‘ื ืงื•ื“ืช ื”ืžืคื ื”, ื”ื’ืคืจื•ืจ ืžืฆื™ืช ืืช ื”ื™ืขืจ.
05:59
Once the forest is ablaze,
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ื‘ืจื’ืข ืฉื”ื™ืขืจ ื ืฉืจืฃ,
06:01
it doesn't do any good to blow out the match.
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ืื™ืŸ ืชื•ืขืœืช ื‘ื›ื™ื‘ื•ื™ ื”ื’ืคืจื•ืจ.
06:04
You have to blow out the match before the forest catches fire.
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ืฆืจื™ืš ืœื›ื‘ื•ืช ืืช ื”ื’ืคืจื•ืจ ืœืคื ื™ ืฉื”ื™ืขืจ ืขื•ืœื” ื‘ืืฉ.
06:08
Even before scientists sort this out,
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ืืคื™ืœื• ืœืคื ื™ ืฉื”ืžื“ืขื ื™ื ืžืกื•ื•ื’ื™ื ืืช ื–ื”.
06:10
this information is actually really good news for us,
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ืžื™ื“ืข ื–ื” ื”ื•ื ืœืžืขืฉื” ื—ื“ืฉื•ืช ื˜ื•ื‘ื•ืช ื‘ืืžืช ืขื‘ื•ืจื ื•,
06:12
because it turns out that the way we live can influence the accumulation
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ื›ื™ ืžืชื‘ืจืจ ืฉื”ื“ืจืš ื‘ื” ืื ื• ื—ื™ื™ื ื™ื›ื•ืœื” ืœื”ืฉืคื™ืข ืขืœ ื”ื”ืฆื˜ื‘ืจื•ืช
06:16
of amyloid plaques.
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ืฉืœ ืจื‘ื“ื™ ื”ืขืžื™ืœื•ืื™ื“.
06:18
And so there are things we can do
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ื•ื›ืš ื™ืฉ ื“ื‘ืจื™ื ืฉืื ื—ื ื• ื™ื›ื•ืœื™ื ืœืขืฉื•ืช
06:19
to keep us from reaching that tipping point.
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ื›ื“ื™ ืœื”ื™ืžื ืข ืžืœื”ื’ื™ืข ืœื ืงื•ื“ืช ื”ืžืคื ื”.
06:22
Let's picture your risk of Alzheimer's as a see-saw scale.
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ื‘ื•ืื• ื•ื ื“ืžื™ื™ืŸ ืืช ื”ืกื™ื›ื•ืŸ ืฉืœื›ื ืœื—ืœื•ืช ื‘ืืœืฆื”ื™ื™ืžืจ ื›ืกืงืืœืช ื ื“ื ื“ื”.
06:26
We're going to pile risk factors on one arm,
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ืื ื—ื ื• ื”ื•ืœื›ื™ื ืœืขืจื•ื ื’ื•ืจืžื™ ืกื™ื›ื•ืŸ ืขืœ ืฆื“ ืื—ื“,
06:28
and when that arm hits the floor, you are symptomatic
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ื›ืฉืฆื“ ื–ื” ืคื•ื’ืข ื‘ืจืฆืคื”, ืืชื ื‘ืขืœื™ ืชืกืžื™ื ื™ื
06:31
and diagnosed with Alzheimer's.
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ื•ืžืื•ื‘ื—ื ื™ื ืขื ืืœืฆื”ื™ื™ืžืจ.
06:33
Let's imagine you're 50 years old.
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ื‘ื•ืื• ื ื“ืžื™ื™ืŸ ืฉืืชื ื‘ื ื™ 50.
06:36
You're not a spring chicken anymore,
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ืืชื ื›ื‘ืจ ืœื ืคืจื’ื™ื•ืช,
06:38
so you've accumulated some amyloid plaques with age.
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ืื– ืฆื‘ืจืชื ืจื•ื‘ื“ ืขืžื™ืœื•ืื™ื“ ื›ืœืฉื”ื• ืขื ื”ื’ื™ืœ.
06:41
Your scale is tipped a little bit.
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ื›ืฃ ื”ืžืื–ื ื™ื™ื ืฉืœื›ื ืžื•ื˜ื” ืžืขื˜.
06:44
Now let's look at your DNA.
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ืขื›ืฉื™ื• ื‘ื•ืื• ื ืกืชื›ืœ ืขืœ ื”ื“ื "ื ืฉืœื›ื.
06:46
We've all inherited our genes from our moms and our dads.
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ื›ื•ืœื ื• ื™ืจืฉื ื• ืืช ื”ื’ื ื™ื ืฉืœื ื• ืžื”ืื™ืžื”ื•ืช ื•ืžื”ืื‘ื•ืช ืฉืœื ื•.
06:49
Some of these genes will increase our risk and some will decrease it.
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ื—ืœืง ืžื”ื’ื ื™ื ื”ืืœื” ื™ื’ื“ื™ืœื• ืืช ื”ืกื™ื›ื•ืŸ ืฉืœื ื• ื•ื—ืœืง ื™ืงื˜ื™ื ื• ืื•ืชื•.
06:54
If you're like Alice in "Still Alice,"
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ืื ืืชื ื›ืžื• ืืœื™ืก ื‘ "ืขื“ื™ื™ืŸ ืืœื™ืก,"
06:56
you've inherited a rare genetic mutation that cranks out amyloid beta,
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ื™ืจืฉืชื ืžื•ื˜ืฆื™ื” ื’ื ื˜ื™ืช ื ื“ื™ืจื” ืฉืžืชื ื™ืขื” ืขืžื™ืœื•ืื™ื“-ื‘ื˜ื,
07:00
and this alone will tip your scale arm to the ground.
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ื•ื–ื” ืœื‘ื“ ื™ื˜ื” ืืช ื”ืฆื“ ืฉืœืš ื‘ื›ืฃ ื”ืžืื–ื ื™ื™ื ืœืงืจืงืข.
07:04
But for most of us, the genes we inherit will only tip the arm a bit.
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ืื‘ืœ ืืฆืœ ืจื•ื‘ื ื•, ื”ื’ื ื™ื ืฉืื ื• ื™ื•ืจืฉื™ื ื™ื˜ื• ืืช ื”ืฆื“ ืฉืœื ื• ืจืง ืงืฆืช.
07:08
For example, APOE4 is a gene variant that increases amyloid,
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APOE4 ื”ื•ื ื’ืจืกื” ื’ื ื˜ื™ืช ืฉืžื’ื‘ื™ืจื” ืขืžื™ืœื•ืื™ื“,
07:13
but you can inherit a copy of APOE4 from mom and dad
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ืื‘ืœ ืืชื ื™ื›ื•ืœื™ื ืœืจืฉืช ืขื•ืชืง ืฉืœ APOE4 ืžืืžื ื•ืžืื‘ื
07:16
and still never get Alzheimer's,
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ื•ืขื“ื™ื™ืŸ ืœื ืชืงื‘ืœื• ืืœืฆื”ื™ื™ืžืจ,
07:19
which means that for most of us,
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ืžื” ืฉืื•ืžืจ, ืฉืขื‘ื•ืจ ืจื•ื‘ื ื•,
07:21
our DNA alone does not determine whether we get Alzheimer's.
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ื”ื“ื "ื ืฉืœื ื• ืœื‘ื“ื• ืื™ื ื• ืงื•ื‘ืข ืื ื ืงื‘ืœ ืืœืฆื”ื™ื™ืžืจ.
07:25
So what does?
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ืื– ืžื” ื›ืŸ ื’ื•ืจื?
07:27
We can't do anything about getting older or the genes we've inherited.
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ืื™ื ื ื• ื™ื›ื•ืœื™ื ืœืขืฉื•ืช ื“ื‘ืจ ื‘ื ื•ื’ืข ืœื”ื–ื“ืงื ื•ืช ืื• ืœื’ื ื™ื ืฉื™ืจืฉื ื•.
07:31
So far, we haven't changed our brain's destiny.
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ืขื“ ื›ื”, ืœื ืฉื™ื ื™ื ื• ืืช ื’ื•ืจืœื• ืฉืœ ื”ืžื•ื— ืฉืœื ื•.
07:34
What about sleep?
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ืžื” ืขื ืฉื™ื ื”?
07:37
In slow-wave deep sleep, our glial cells rinse cerebral spinal fluid
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ื‘ืฉื™ื ื” ืฉืœ ื’ืœื™ื ืื™ื˜ื™ื™ื, ืชืื™ ื”ื’ึฐืœึดื™ื™ึธื” ืฉืœื ื• ืฉื•ื˜ืคื™ื ืืช ื”ื ื•ื–ืœ ื”ืžื•ื—ื™ ื”ืฉื“ืจืชื™
07:41
throughout our brains,
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ืœืื•ืจืš ื”ืžื•ื— ืฉืœื ื•,
07:42
clearing away metabolic waste that accumulated in our synapses
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ื•ืžื ืงื™ื ืคืกื•ืœืช ืžื˜ื‘ื•ืœื™ืช ืฉื”ืฆื˜ื‘ืจื” ื‘ืกื™ื ืคืกื•ืช ืฉืœื ื•
07:46
while we were awake.
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ื›ืฉื”ื™ื™ื ื• ืขืจื™ื.
07:47
Deep sleep is like a power cleanse for the brain.
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ืฉื™ื ื” ืขืžื•ืงื” ื”ื™ื ื›ืžื• ื˜ื™ื”ื•ืจ ืขืžื•ืง ืœืžื•ื—.
07:51
But what happens if you shortchange yourself on sleep?
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ืื‘ืœ ืžื” ืงื•ืจื” ืื ืื™ื ื›ื ื™ืฉื ื™ื ื›ืจืื•ื™?
07:55
Many scientists believe
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ืžื“ืขื ื™ื ืจื‘ื™ื ืžืืžื™ื ื™ื
07:56
that poor sleep hygiene might actually be a predictor of Alzheimer's.
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ืฉื”ื™ื’ื™ื™ื ืช ืฉื™ื ื” ื’ืจื•ืขื” ืขืฉื•ื™ื” ืœื”ื•ื•ืช ืžื ื‘ื ืฉืœ ืืœืฆื”ื™ื™ืžืจ.
08:01
A single night of sleep deprivation leads to an increase in amyloid beta.
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ืœื™ืœื” ืื—ื“ ืœืœื ืฉื™ื ื” ืžื•ื‘ื™ืœ ืœืขืœื™ื™ื” ื‘ืขืžื™ืœื•ืื™ื“-ื‘ื˜ื.
08:07
And amyloid accumulation has been shown to disrupt sleep,
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ื•ื”ืฆื˜ื‘ืจื•ืช ืขืžื™ืœื•ืื™ื“ื™ืช ื”ื•ื›ื—ื” ื›ืžืคืจื™ืขื” ืœืฉื™ื ื”,
08:10
which in turn causes more amyloid to accumulate.
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ืฉื‘ืชื•ืจื” ื’ื•ืจืžืช ืœื™ื•ืชืจ ืขืžื™ืœื•ืื™ื“ ืœื”ืฆื˜ื‘ืจ.
08:13
And so now we have this positive feedback loop
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ื•ื›ืš ื™ืฉ ืœื ื• ื›ืขืช ืœื•ืœืืช ืžืฉื•ื‘ ื—ื™ื•ื‘ื™ ื–ืืช
08:15
that's going to accelerate the tipping of that scale.
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ืฉืชืื™ืฅ ืืช ื”ื”ื˜ื™ื™ื” ืฉืœ ืกื•ืœื ื–ื”.
08:19
What else?
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ืžื” ืขื•ื“?
08:20
Cardiovascular health.
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ื‘ืจื™ืื•ืช ื”ืœื‘ ื•ื›ืœื™ ื”ื“ื.
08:22
High blood pressure, diabetes, obesity, smoking, high cholesterol,
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ืœื—ืฅ ื“ื ื’ื‘ื•ื”, ืกื•ื›ืจืช, ื”ืฉืžื ืช ื™ืชืจ, ืขื™ืฉื•ืŸ, ื›ื•ืœืกื˜ืจื•ืœ ื’ื‘ื•ื”,
08:26
have all been shown to increase our risk of developing Alzheimer's.
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ื›ืœ ืืœื” ื ืฆืคื• ื›ืžื’ื“ื™ืœื™ื ืืช ื”ืกื™ื›ื•ืŸ ืฉืœื ื• ืœื”ืชืคืชื—ื•ืช ืืœืฆื”ื™ื™ืžืจ.
08:30
Some autopsy studies have shown
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ื›ืžื” ืžื—ืงืจื™ื ืฉืœ ื‘ื“ื™ืงื•ืช ืœืื—ืจ ื”ืžื•ื•ืช ื”ืจืื•
08:32
that as many as 80 percent of people with Alzheimer's
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ืฉื›-80 ืื—ื•ื–ื™ื ืฉืœ ืื ืฉื™ื ืขื ืืœืฆื”ื™ื™ืžืจ
08:35
also had cardiovascular disease.
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ืกื‘ืœื• ื’ื ืžืžื—ืœื•ืช ืœื‘ ื•ื›ืœื™ ื“ื.
08:38
Aerobic exercise has been shown in many studies to decrease amyloid beta
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ืชืจื’ื•ืœ ืื™ืจื•ื‘ื™ ื”ืจืื” ื‘ืžื—ืงืจื™ื ืจื‘ื™ื ื›ืžืคื—ื™ืช ืืช ื”ืขืžื™ืœื•ืื™ื“-ื‘ื˜ื
08:43
in animal models of the disease.
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ื‘ืžื•ื“ืœื™ื ืฉืœ ื”ืžื—ืœื” ื‘ื‘ืขืœื™ ื—ื™ื™ื.
08:45
So a heart-healthy Mediterranean lifestyle and diet
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ืื– ืื•ืจื— ื—ื™ื™ื ื™ื ืชื™ื›ื•ื ื™, ื•ื“ื™ืื˜ื”, ืฉื‘ืจื™ืื™ื ืœืœื‘
08:49
can help to counter the tipping of this scale.
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ื™ื›ื•ืœื™ื ืœืขื–ื•ืจ ื›ื ื’ื“ ื”ื”ื˜ื™ื™ื” ืฉืœ ืกื•ืœื ื–ื”.
08:52
So there are many things we can do
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ืื– ื™ืฉ ื”ืจื‘ื” ื“ื‘ืจื™ื ืฉืื ื—ื ื• ื™ื›ื•ืœื™ื ืœืขืฉื•ืช
08:54
to prevent or delay the onset of Alzheimer's.
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ื›ื“ื™ ืœืžื ื•ืข ืื• ืœืขื›ื‘ ืืช ื”ื•ืคืขืช ื”ืืœืฆื”ื™ื™ืžืจ.
08:57
But let's say you haven't done any of them.
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ืื‘ืœ ื ื ื™ื— ืฉืœื ืขืฉื™ืชื ืืฃ ืื—ื“ ืžื”ื.
09:00
Let's say you're 65;
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ื ื ื™ื— ืฉืืชื ื‘ื ื™ 65;
09:02
there's Alzheimer's in your family, so you've likely inherited a gene or two
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ื™ืฉ ืืœืฆื”ื™ื™ืžืจ ื‘ืžืฉืคื—ื” ืฉืœื›ื ืื– ื›ื ืจืื” ืฉื™ืจืฉืชื ื’ืŸ ืื• ืฉื ื™ื™ื
09:06
that tips your scale arm a bit;
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ืฉืžื˜ื” ืืช ื›ืฃ ื”ืžืื–ื ื™ื™ื ืžืขื˜;
09:08
you've been burning the candle at both ends for years;
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ืฉืจืคืชื ืืช ื”ื ืจ ื‘ืฉื ื™ ื”ืงืฆื•ื•ืช ืœืื•ืจืš ืฉื ื™ื;
09:11
you love bacon;
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ืืชื ืื•ื”ื‘ื™ื ื‘ื™ื™ืงื•ืŸ;
09:12
and you don't run unless someone's chasing you.
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ื•ืื™ื ื›ื ืจืฆื™ื ืืœื ืื ื›ืŸ ืžื™ืฉื”ื• ืจื•ื“ืฃ ืื—ืจื™ื›ื.
09:14
(Laughter)
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(ืฆื—ื•ืง)
09:16
Let's imagine that your amyloid plaques have reached that tipping point.
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ื‘ื•ืื• ื ื“ืžื™ื™ืŸ ืฉืจื‘ื“ื™ ื”ืขืžื™ืœื•ืื™ื“ ืฉืœื›ื ื”ื’ื™ืขื• ืœื ืงื•ื“ืช ื”ืžืคื ื” ื”ื–ืืช.
09:19
Your scale arm has crashed to the floor.
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ื›ืฃ ื”ืžืื–ื ื™ื™ื ื”ืชืจืกืงื” ืœืจืฆืคื”.
09:21
You've tripped the cascade,
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ื”ื›ืฉืœืชื ืืช ื”ืžืคืœ,
09:23
setting fire to the forest,
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ื”ื‘ืขืจืชื ืืช ื”ื™ืขืจ.
09:25
causing inflammation, tangles, and cell death.
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ื’ืจืžืชื ืœื“ืœืงืช, ืกื‘ื›ื™ื ื•ืžื•ื•ืช ืชืื™ื,
09:28
You should be symptomatic for Alzheimer's.
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ืฆืจื™ื›ื™ื ืœื”ื™ื•ืช ืœื›ื ืชืกืžื™ื ื™ื ืฉืœ ืืœืฆื”ื™ื™ืžืจ.
09:31
You should be having trouble finding words and keys
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ืฆืจื™ื›ื•ืช ืœื”ื™ื•ืช ืœื›ื ื‘ืขื™ื•ืช ื‘ืžืฆื™ืืช ืžื™ืœื™ื ื•ืžืคืชื—ื•ืช
09:34
and remembering what I said at the beginning of this talk.
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ื•ืœื–ื›ื•ืจ ืืช ืžื” ืฉืืžืจืชื™ ื‘ืชื—ื™ืœืช ื”ืฉื™ื—ื”.
09:38
But you might not be.
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ืื‘ืœ ืื•ืœื™ ืœื.
09:41
There's one more thing you can do to protect yourself
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ื™ืฉ ืขื•ื“ ื“ื‘ืจ ืื—ื“ ืฉืืชื ื™ื›ื•ืœื™ื ืœืขืฉื•ืช ื›ื“ื™ ืœื”ื’ืŸ ืขืœ ืขืฆืžื›ื
09:43
from experiencing the symptoms of Alzheimer's,
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ืžืœื—ื•ื•ืช ืชืกืžื™ื ื™ื ืฉืœ ืืœืฆื”ื™ื™ืžืจ,
09:46
even if you have the full-blown disease pathology ablaze in your brain.
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ื’ื ืื ื”ืคืชื•ืœื•ื’ื™ื” ืฉืœ ื”ืžื—ืœื” ื‘ื•ืขืจืช ื‘ืžื•ื— ืฉืœื›ื.
09:50
It has to do with neural plasticity and cognitive reserve.
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ื–ื” ืงืฉื•ืจ ืœืคืœืกื˜ื™ื•ืช ืขืฆื‘ื™ืช ื•ืขืชื•ื“ื” ืงื•ื’ื ื™ื˜ื™ื‘ื™ืช.
09:55
Remember, the experience of having Alzheimer's
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ื–ื™ื›ืจื•, ื”ื—ื•ื•ื™ื™ื” ืฉืœ ืžื—ืœืช ื”ืืœืฆื”ื™ื™ืžืจ
09:57
is ultimately a result of losing synapses.
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ื”ื™ื ื‘ืกื•ืคื• ืฉืœ ื“ื‘ืจ ืชื•ืฆืื” ืฉืœ ืื•ื‘ื“ืŸ ื”ืกื™ื ืคืกื•ืช.
10:01
The average brain has over a hundred trillion synapses,
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ื‘ืžื•ื— ื”ืžืžื•ืฆืข ื™ืฉ ืžืขืœ ืžืื” ื˜ืจื™ืœื™ื•ืŸ ืกื™ื ืคืกื•ืช,
10:04
which is fantastic; we've got a lot to work with.
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ื•ื–ื” ืคื ื˜ืกื˜ื™; ื™ืฉ ืœื ื• ื”ืจื‘ื” ืขื ืžื” ืœืขื‘ื•ื“.
10:07
And this isn't a static number.
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ื•ื–ื” ืœื ืžืกืคืจ ืกื˜ื˜ื™.
10:08
We gain and lose synapses all the time,
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ืื ื—ื ื• ืžืงื‘ืœื™ื ื•ืžืื‘ื“ื™ื ืกื™ื ืคืกื•ืช ื›ืœ ื”ื–ืžืŸ,
10:11
through a process called neural plasticity.
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ื‘ืืžืฆืขื•ืช ืชื”ืœื™ืš ืฉื ืงืจื ืคืœืกื˜ื™ื•ืช ืขืฆื‘ื™ืช.
10:14
Every time we learn something new,
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ื‘ื›ืœ ืคืขื ืฉืื ื—ื ื• ืœื•ืžื“ื™ื ืžืฉื”ื• ื—ื“ืฉ,
10:16
we are creating and strengthening new neural connections,
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ืื ื• ื™ื•ืฆืจื™ื ื•ืžื—ื–ืงื™ื ืงืฉืจื™ื ืขืฆื‘ื™ื™ื ื—ื“ืฉื™ื,
10:20
new synapses.
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ืกื™ื ืคืกื•ืช ื—ื“ืฉื•ืช.
10:22
In the Nun Study,
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ื‘ืžื—ืงืจ ื”ื ื–ื™ืจื•ืช,
10:24
678 nuns, all over the age of 75 when the study began,
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678 ื ื–ื™ืจื•ืช, ื›ื•ืœืŸ ืžืขืœ ื’ื™ืœ 75 ื›ืืฉืจ ื”ืžื—ืงืจ ื”ื—ืœ,
10:29
were followed for more than two decades.
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ื•ืขืงื‘ื• ืื—ืจื™ื”ืŸ ื‘ืžืฉืš ื™ื•ืชืจ ืžืฉื ื™ ืขืฉื•ืจื™ื.
10:31
They were regularly given physical checkups and cognitive tests,
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ื”ืŸ ืขื‘ืจื• ื‘ืงื‘ื™ืขื•ืช ื‘ื“ื™ืงื•ืช ืคื™ื–ื™ื•ืช ื•ืžื‘ื—ื ื™ื ืงื•ื’ื ื™ื˜ื™ื‘ื™ื™ื,
10:35
and when they died, their brains were all donated for autopsy.
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ื•ื›ืืฉืจ ื”ืŸ ื ืคื˜ืจื•, ื”ืžื•ื—ื•ืช ืฉืœื”ืŸ ื›ื•ืœื ื ืชืจืžื• ืœื ืชื™ื—ื”.
10:39
In some of these brains, scientists discovered something surprising.
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ื‘ื—ืœืง ืžื”ืžื•ื—ื•ืช ื”ืืœื”, ืžื“ืขื ื™ื ื’ื™ืœื• ืžืฉื”ื• ืžืคืชื™ืข.
10:43
Despite the presence of plaques and tangles and brain shrinkage --
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ืœืžืจื•ืช ื”ื™ืžืฆืื•ืชื ืฉืœ ืจื‘ื“ื™ื, ื•ืกื‘ื›ื™ื ื•ื”ืชื›ื•ื•ืฆื•ืช ื”ืžื•ื—ื•ืช -
10:48
what appeared to be unquestionable Alzheimer's --
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ืžื” ืฉื ืจืื” ืœืœื ืกืคืง ื›ืืœืฆื”ื™ื™ืžืจ -
10:51
the nuns who had belonged to these brains showed no signs
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ื”ื ื–ื™ืจื•ืช ืฉื”ื™ื• ื‘ืขืœื•ืช ื”ืžื•ื—ื•ืช ื”ืืœื” ืœื ื”ืจืื• ื›ืœ ืกื™ืžื ื™ื
10:54
of having the disease while they were alive.
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ื›ื—ื•ืœื•ืช ื‘ืžื—ืœื” ื‘ืขื•ื“ืŸ ื‘ื—ื™ื™ื.
10:58
How can this be?
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ืื™ืš ื–ื” ื™ื›ื•ืœ ืœื”ื™ื•ืช?
10:59
We think it's because these nuns had a high level of cognitive reserve,
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ืื ื—ื ื• ื—ื•ืฉื‘ื™ื ืฉื–ื” ื‘ื’ืœืœ ืฉืœื ื–ื™ืจื•ืช ื”ืืœื” ื”ื™ืชื” ืจืžื” ื’ื‘ื•ื”ื” ืฉืœ ืขืชื•ื“ื” ืงื•ื’ื ื™ื˜ื™ื‘ื™ืช,
11:03
which is a way of saying that they had more functional synapses.
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ืฉื–ื•ื”ื™ ื“ืจืš ืœื•ืžืจ ืฉื”ื™ื• ืœื”ืŸ ื™ื•ืชืจ ืกื™ื ืคืกื•ืช ืคืขื™ืœื•ืช.
11:07
People who have more years of formal education,
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ืื ืฉื™ื ื‘ืขืœื™ ื™ื•ืชืจ ืฉื ื™ื ืฉืœ ื—ื™ื ื•ืš ืคื•ืจืžืœื™,
11:10
who have a high degree of literacy,
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ืฉื”ื ื‘ืขืœื™ ืจืžื” ื’ื‘ื•ื”ื” ืฉืœ ืื•ืจื™ื™ื ื•ืช,
11:12
who engage regularly in mentally stimulating activities,
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ืฉืขื•ืกืงื™ื ื‘ืื•ืคืŸ ืงื‘ื•ืข ื‘ืคืขื™ืœื•ืช ืžื ื˜ืœื™ืช ืžื’ืจื”,
11:16
all have more cognitive reserve.
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ืœื›ื•ืœื ื™ืฉ ื™ื•ืชืจ ืขืชื•ื“ื” ืงื•ื’ื ื™ื˜ื™ื‘ื™ืช .
11:18
They have an abundance and a redundancy in neural connections.
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ื™ืฉ ืœื”ื ืฉืคืข ื•ืขื•ื“ืฃ ืฉืœ ื—ื™ื‘ื•ืจื™ื ืขืฆื‘ื™ื™ื.
11:23
So even if they have a disease like Alzheimer's
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ื›ืš ืฉื’ื ืื ื™ืฉ ืœื”ื ืžื—ืœื” ื›ืžื• ืืœืฆื”ื™ื™ืžืจ
11:25
compromising some of their synapses,
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ืฉืคื•ื’ืขืช ื‘ื—ืœืง ืžื”ืกื™ื ืคืกื•ืช ืฉืœื”ื,
11:27
they've got many extra backup connections,
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ื™ืฉ ืœื”ื ื”ืจื‘ื” ื’ื™ื‘ื•ื™ ืฉืœ ื—ื™ื‘ื•ืจื™ื ื ื•ืกืคื™ื,
11:30
and this buffers them from noticing that anything is amiss.
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ื•ื–ื” ืžื•ื ืข ืžื‘ืขื“ื ืžืœืฉื™ื ืœื‘ ืฉืžืฉื”ื• ืœื ื‘ืกื“ืจ.
11:34
Let's imagine a simplified example.
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ื‘ื•ืื• ื•ื ื“ืžื™ื™ืŸ ื“ื•ื’ืžื” ืคืฉื•ื˜ื”.
11:37
Let's say you only know one thing about a subject.
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ื ื ื™ื— ืฉืืชื ื™ื•ื“ืขื™ื ืจืง ื“ื‘ืจ ืื—ื“ ืขืœ ื ื•ืฉื.
11:39
Let's say it's about me.
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ื‘ื•ื ื ื’ื™ื“ ืฉื–ื” ืงืฉื•ืจ ืืœื™.
11:41
You know that Lisa Genova wrote "Still Alice,"
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ืืชื ื™ื•ื“ืขื™ื ืฉืœื™ืกื” ื’'ื ื•ื‘ื” ื›ืชื‘ื” ืืช "ืขื“ื™ื™ืŸ ืืœื™ืก"
11:43
and that's the only thing you know about me.
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ื•ื–ื” ื”ื“ื‘ืจ ื”ื™ื—ื™ื“ื™ ืฉืืชื ื™ื•ื“ืขื™ื ืขืœื™.
11:46
You have that single neural connection,
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ื™ืฉ ืœื›ื ืืช ื”ื—ื™ื‘ื•ืจ ื”ืขืฆื‘ื™ ื”ื™ื—ื™ื“,
11:48
that one synapse.
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ืกื™ื ืคืกื” ืื—ืช ื–ื•.
11:50
Now imagine you have Alzheimer's.
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ืขื›ืฉื™ื• ืชืืจื• ืœืขืฆืžื›ื ืฉื™ืฉ ืœื›ื ืืœืฆื”ื™ื™ืžืจ.
11:52
You have plaques and tangles and inflammation
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ื™ืฉ ืœื›ื ืจื‘ื“ื™ื, ื•ืกื‘ื›ื™ื, ื•ื“ืœืงืช
11:55
and microglia devouring that synapse.
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ื•ืžื™ืงืจื•ื’ืœื™ื™ื” ืฉื˜ื•ืจืคืช ืืช ื”ืกื™ื ืคืกื”.
11:58
Now when someone asks you, "Hey, who wrote 'Still Alice?'"
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ืขื›ืฉื™ื• ื›ืฉืžื™ืฉื”ื• ืฉื•ืืœ ืืชื›ื, "ื”ื™ื™, ืžื™ ื›ืชื‘ ืืช "ืขื“ื™ื™ืŸ ืืœื™ืก?"
12:02
you can't remember,
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ืืชื ืœื ื™ื›ื•ืœื™ื ืœื–ื›ื•ืจ,
12:03
because that synapse is either failing or gone.
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ื›ื™ ืกื™ื ืคืกื” ื–ื• ื›ื‘ืจ ืœืงื•ื™ื” ืื• ื ืขืœืžื”.
12:07
You've forgotten me forever.
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ืฉื›ื—ืชื ืื•ืชื™ ืœื ืฆื—.
12:09
But what if you had learned more about me?
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ืื‘ืœ ืžื” ืื ื”ื™ื™ืชื ืœื•ืžื“ื™ื ืขืœื™ื™ ื™ื•ืชืจ?
12:12
Let's say you learned four things about me.
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ื ื ื™ื— ืฉืœืžื“ืชื ืขืœื™ ืืจื‘ืขื” ื“ื‘ืจื™ื.
12:14
Now imagine you have Alzheimer's,
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ื›ืขืช, ื“ืžื™ื™ื ื• ืฉื™ืฉ ืœื›ื ืืœืฆื”ื™ื™ืžืจ,
12:16
and three of those synapses are damaged or destroyed.
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ื•ืฉืœื•ืฉ ืžืื•ืชืŸ ืกื™ื ืคืกื•ืช ื ื™ื–ื•ืงื• ืื• ื ื”ืจืกื•.
12:19
You still have a way to detour the wreckage.
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ืขื“ื™ื™ืŸ ื™ืฉ ืœื›ื ื“ืจืš ืœืขืงื•ืฃ ืืช ื”ื”ืจื™ืกื•ืช.
12:22
You can still remember my name.
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ืืชื ืขื“ื™ื™ืŸ ื–ื•ื›ืจื™ื ืืช ืฉืžื™.
12:25
So we can be resilient to the presence of Alzheimer's pathology
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ืื– ืื ื—ื ื• ื™ื›ื•ืœื™ื ืœื”ื™ื•ืช ื’ืžื™ืฉื™ื ืœื ื•ื›ื—ื•ืช ื”ืคืชื•ืœื•ื’ื™ื” ืฉืœ ื”ืืœืฆื”ื™ื™ืžืจ
12:29
through the recruitment of yet-undamaged pathways.
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ื‘ืืžืฆืขื•ืช ื’ื™ื•ืก ืฉืœ ืžืกืœื•ืœื™ื ืฉื˜ืจื ื ืคื’ืขื•.
12:32
And we create these pathways, this cognitive reserve,
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ื•ืื ื—ื ื• ื™ื•ืฆืจื™ื ืžืกืœื•ืœื™ื ืืœื”, ืขืชื•ื“ื” ืงื•ื’ื ื™ื˜ื™ื‘ื™ืช ื–ื•,
12:35
by learning new things.
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ืขืœ ื™ื“ื™ ืœืžื™ื“ื” ืฉืœ ื“ื‘ืจื™ื ื—ื“ืฉื™ื.
12:38
Ideally, we want these new things to be as rich in meaning as possible,
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ื‘ืื•ืคืŸ ืื™ื“ื™ืืœื™, ืื ื• ืจื•ืฆื™ื ืฉื“ื‘ืจื™ื ื—ื“ืฉื™ื ืืœื”, ื™ื”ื™ื• ืขืฉื™ืจื™ื ื•ื‘ืขืœื™ ืžืฉืžืขื•ืช, ื›ื›ืœ ื”ืืคืฉืจ,
12:42
recruiting sight and sound and associations and emotion.
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ืชื•ืš ื’ื™ื•ืก ืฉืœ ืžืจืื•ืช ื•ืฆืœื™ืœื™ื, ื•ืืกื•ืฆื™ืืฆื™ื•ืช ื•ืจื’ืฉ.
12:48
So this really doesn't mean doing crossword puzzles.
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ื›ืš ืฉื–ื” ืžืžืฉ ืœื ืื•ืžืจ ืœืคืชื•ืจ ืชืฉื‘ืฆื™ื.
12:51
You don't want to simply retrieve information you've already learned,
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ืื™ื ื›ื ืจื•ืฆื™ื ืคืฉื•ื˜ ืœืื—ื–ืจ ืžื™ื“ืข ืฉื›ื‘ืจ ืœืžื“ืชื,
12:55
because this is like traveling down old, familiar streets,
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ื›ื™ ื–ื” ื›ืžื• ืœื ืกื•ืข ื‘ืจื—ื•ื‘ื•ืช ื™ืฉื ื™ื, ื•ืžื•ื›ืจื™ื,
12:58
cruising neighborhoods you already know.
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ืœื ืกื•ืข ื‘ืฉื›ื•ื ื•ืช ืฉืืชื ื›ื‘ืจ ืžื›ื™ืจื™ื.
13:01
You want to pave new neural roads.
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ืืชื ืจื•ืฆื™ื ืœืกืœื•ืœ ื›ื‘ื™ืฉื™ื ืขืฆื‘ื™ื™ื ื—ื“ืฉื™ื.
13:04
Building an Alzheimer's-resistant brain
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ืœื‘ื ื•ืช ืžื•ื— ืขืžื™ื“ ืœืืœืฆื”ื™ื™ืžืจ
13:07
means learning to speak Italian,
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ืคื™ืจื•ืฉื• ืœืœืžื•ื“ ืœื“ื‘ืจ ืื™ื˜ืœืงื™ืช,
13:09
meeting new friends,
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ืœืคื’ื•ืฉ ื—ื‘ืจื™ื ื—ื“ืฉื™ื,
13:11
reading a book,
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ืœืงืจื•ื ืกืคืจ,
13:12
or listening to a great TED Talk.
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ืื• ืœื”ืงืฉื™ื‘ ืœื”ืจืฆืืช TED ืžืขื•ืœื”.
13:15
And if, despite all of this, you are someday diagnosed with Alzheimer's,
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ื•ืื, ืœืžืจื•ืช ื›ืœ ื–ื”, ืชืื•ื‘ื—ื ื• ื™ื•ื ืื—ื“ ืขื ืืœืฆื”ื™ื™ืžืจ,
13:20
there are three lessons I've learned from my grandmother
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ื™ืฉ ืฉืœื•ืฉื” ืœืงื—ื™ื ืฉืœืžื“ืชื™ ืžืกื‘ืชื™
13:23
and the dozens of people I've come to know living with this disease.
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ื•ืžืขืฉืจื•ืช ื”ืื ืฉื™ื ืฉื”ื›ืจืชื™ ืฉื—ื•ืœื™ื ื‘ืžื—ืœื” ื”ื–ื•,
13:27
Diagnosis doesn't mean you're dying tomorrow.
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ืื‘ื—ื•ืŸ ืœื ืื•ืžืจ ืฉืืชื ื’ื•ืกืกื™ื ืžื—ืจ.
13:31
Keep living.
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ื”ืžืฉื™ื›ื• ืœื—ื™ื•ืช.
13:32
You won't lose your emotional memory.
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ืืชื ืœื ืชืื‘ื“ื• ืืช ื”ื–ื™ื›ืจื•ืŸ ื”ืจื’ืฉื™ ืฉืœื›ื.
13:35
You'll still be able to understand love and joy.
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ืขื“ื™ื™ืŸ ืชื•ื›ืœื• ืœื”ื‘ื™ืŸ ืื”ื‘ื” ื•ืฉืžื—ื”.
13:38
You might not remember what I said five minutes ago,
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ืืชื ืขืœื•ืœื™ื ืœื ืœื–ื›ื•ืจ ืืช ืžื” ืฉืืžืจืชื™ ืœืคื ื™ ื—ืžืฉ ื“ืงื•ืช,
13:41
but you'll remember how I made you feel.
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ืื‘ืœ ืชื–ื›ืจื• ืื™ืš ื’ืจืžืชื™ ืœื›ื ืœื”ืจื’ื™ืฉ.
13:44
And you are more than what you can remember.
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ืืชื ื™ื•ืชืจ ืžืžื” ืฉืืชื ื™ื›ื•ืœื™ื ืœื–ื›ื•ืจ.
13:48
Thank you.
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ืชื•ื“ื”.
13:49
(Applause)
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(ืžื—ื™ืื•ืช ื›ืคื™ื™ื)
ืขืœ ืืชืจ ื–ื”

ืืชืจ ื–ื” ื™ืฆื™ื’ ื‘ืคื ื™ื›ื ืกืจื˜ื•ื ื™ YouTube ื”ืžื•ืขื™ืœื™ื ืœืœื™ืžื•ื“ ืื ื’ืœื™ืช. ืชื•ื›ืœื• ืœืจืื•ืช ืฉื™ืขื•ืจื™ ืื ื’ืœื™ืช ื”ืžื•ืขื‘ืจื™ื ืขืœ ื™ื“ื™ ืžื•ืจื™ื ืžื”ืฉื•ืจื” ื”ืจืืฉื•ื ื” ืžืจื—ื‘ื™ ื”ืขื•ืœื. ืœื—ืฅ ืคืขืžื™ื™ื ืขืœ ื”ื›ืชื•ื‘ื™ื•ืช ื‘ืื ื’ืœื™ืช ื”ืžื•ืฆื’ื•ืช ื‘ื›ืœ ื“ืฃ ื•ื™ื“ืื• ื›ื“ื™ ืœื”ืคืขื™ืœ ืืช ื”ืกืจื˜ื•ืŸ ืžืฉื. ื”ื›ืชื•ื‘ื™ื•ืช ื’ื•ืœืœื•ืช ื‘ืกื ื›ืจื•ืŸ ืขื ื”ืคืขืœืช ื”ื•ื•ื™ื“ืื•. ืื ื™ืฉ ืœืš ื”ืขืจื•ืช ืื• ื‘ืงืฉื•ืช, ืื ื ืฆื•ืจ ืื™ืชื ื• ืงืฉืจ ื‘ืืžืฆืขื•ืช ื˜ื•ืคืก ื™ืฆื™ืจืช ืงืฉืจ ื–ื”.

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