TED2017
Lisa Genova: What you can do to prevent Alzheimer's
Lisa Genova: Što preventivno možete učiniti protiv Alzheimerove bolesti?
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4,830,426 views
Alzheimerova bolest ne mora biti sudbina vašeg mozga, kaže neuroznanstvenica i autorica knjige 'I dalje Alice', Lisa Genova. Podijelila je zadnja znanstvena saznanja u istraživanju bolesti -- i neka obećavajuća istraživanja o tome što svatko od nas može učiniti kako bi svoj mozak učinio otpornijim na Alzheimerovu bolest.
Lisa Genova - Neuroscientist, novelist
Through her fiction, Lisa Genova beckons us into the lives of people with neurological disease, making their worlds real and relatable. Full bio
Through her fiction, Lisa Genova beckons us into the lives of people with neurological disease, making their worlds real and relatable. Full bio
Double-click the English transcript below to play the video.
00:13
How many people here would like to live
to be at least 80 years old?
to be at least 80 years old?
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Koliko ljudi ovdje bi htjelo doživjeti
barem 80 godina?
barem 80 godina?
00:18
Yeah.
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Da.
00:19
I think we all have
this hopeful expectation
this hopeful expectation
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Mislim da svi imamo
ovakvo očekivanje puno nade
ovakvo očekivanje puno nade
00:22
of living into old age.
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od života u kasnoj dobi.
00:24
Let's project out into the future,
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Prebacimo se u budućnost,
00:26
to your future "you's,"
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na vaše buduće 'vi',
00:28
and let's imagine that we're all 85.
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i zamislimo da svi imamo 85 godina.
00:31
Now, everyone look at two people.
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Sada neka svatko pogleda dvije osobe.
00:35
One of you probably has
Alzheimer's disease.
Alzheimer's disease.
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Jedna od vas vjerojatno ima
Alzheimerovu bolest.
Alzheimerovu bolest.
00:39
(Laughter)
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(Smijeh)
00:42
Alright, alright.
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U redu.
00:44
And maybe you're thinking,
"Well, it won't be me."
"Well, it won't be me."
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I možda mislite,
"Pa, to neću biti ja."
"Pa, to neću biti ja."
00:49
Then, OK. You are a caregiver.
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U redu. Onda ste njegovatelj.
00:53
So --
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Dakle --
00:54
(Laughter)
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(Smijeh)
00:57
so in some way,
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na neki način,
00:58
this terrifying disease
is likely to affect us all.
is likely to affect us all.
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ova zastrašujuća bolest
vjerojatno će pogoditi sve nas.
vjerojatno će pogoditi sve nas.
01:02
Part of the fear around Alzheimer's
stems from the sense
stems from the sense
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Dio straha vezanog za Alzheimera
proizlazi iz osjećaja
proizlazi iz osjećaja
01:05
that there's nothing we can do about it.
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da ništa ne možemo učiniti po tom pitanju.
01:08
Despite decades of research, we still
have no disease-modifying treatment
have no disease-modifying treatment
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Unatoč desetljećima istraživanja,
još nemamo način utjecaja na bolest
još nemamo način utjecaja na bolest
01:13
and no cure.
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kao ni lijek.
01:15
So if we're lucky enough
to live long enough,
to live long enough,
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Pa ako imamo dovoljno sreće i dugo živimo,
01:17
Alzheimer's appears to be
our brain's destiny.
our brain's destiny.
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čini se da je naš mozak
osuđen na Alzheimera.
osuđen na Alzheimera.
01:21
But maybe it doesn't have to be.
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A možda i ne mora biti tako.
01:23
What if I told you we could
change these statistics,
change these statistics,
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Što kada bih vam rekla
da možemo izmijeniti ovu statistiku,
da možemo izmijeniti ovu statistiku,
01:26
literally change our brain's destiny,
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doslovno promijeniti sudbinu našeg mozga,
01:29
without relying on a cure
or advancements in medicine?
or advancements in medicine?
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bez oslanjanja na lijekove
ili napretke u medicini?
ili napretke u medicini?
01:33
Let's begin by looking at
what we currently understand
what we currently understand
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Počnimo od promatranja onoga
što trenutno razumijemo
što trenutno razumijemo
01:36
about the neuroscience of Alzheimer's.
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iz neuroznanosti vezano za Alzheimera.
01:39
Here's a picture
of two neurons connecting.
of two neurons connecting.
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Ovo je slika dva povezana neurona.
01:42
The point of connection,
this space circled in red,
this space circled in red,
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Točka spajanja,
ovaj prostor zaokružen crveno,
ovaj prostor zaokružen crveno,
01:46
is called the synapse.
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zove se sinapsa.
01:47
The synapse is where
neurotransmitters are released.
neurotransmitters are released.
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Na sinapsi se oslobađaju neurotransmiteri.
01:51
This is where signals are transmitted,
where communication happens.
where communication happens.
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Tu se prenose signali
i događa komunikacija.
i događa komunikacija.
01:55
This is where we think,
feel, see, hear, desire ...
feel, see, hear, desire ...
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To je mjesto gdje razmišljamo, osjećamo,
vidimo, čujemo, žudimo...
vidimo, čujemo, žudimo...
02:00
and remember.
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i pamtimo.
02:02
And the synapse
is where Alzheimer's happens.
is where Alzheimer's happens.
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A upravo na sinapsi se javlja Alzheimer.
02:05
Let's zoom in on the synapse
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Uvećajmo prikaz sinapse
02:07
and look at a cartoon representation
of what's going on.
of what's going on.
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i pogledajmo crtani prikaz
onoga što se ovdje događa.
onoga što se ovdje događa.
02:10
During the business
of communicating information,
of communicating information,
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Za vrijeme procesa prijenosa informacija,
02:13
in addition to releasing neurotransmitters
like glutamate into the synapse,
like glutamate into the synapse,
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uz otpuštanje neurotransmitera,
poput glutamina, u sinapse,
poput glutamina, u sinapse,
02:17
neurons also release a small peptide
called amyloid beta.
called amyloid beta.
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neuroni otpuštaju i mali peptid,
nazvan beta amiloid.
nazvan beta amiloid.
02:22
Normally, amyloid beta is cleared away
metabolized by microglia,
metabolized by microglia,
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Redovno, beta amiloid se čisti
i metabolizira od strane mikroglije,
i metabolizira od strane mikroglije,
02:27
the janitor cells of our brains.
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čistača stanica u našem mozgu.
02:30
While the molecular causes
of Alzheimer's are still debated,
of Alzheimer's are still debated,
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Dok se o molekularnim uzrocima Alzheimera
još uvijek raspravlja,
još uvijek raspravlja,
02:34
most neuroscientists believe
that the disease begins
that the disease begins
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većina neuroznanstvenika vjeruje
da bolest počinje
da bolest počinje
02:37
when amyloid beta begins to accumulate.
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kada se beta amiloid počinje nakupljati.
02:40
Too much is released,
or not enough is cleared away,
or not enough is cleared away,
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Previše je otpušteno,
ili je nedovoljno pročišćeno,
ili je nedovoljno pročišćeno,
02:43
and the synapse begins
to pile up with amyloid beta.
to pile up with amyloid beta.
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i sinapsa počinje gomilati beta amiloid.
02:47
And when this happens, it binds to itself,
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I kada se to dogodi, veže ga za sebe,
02:49
forming sticky aggregates
called amyloid plaques.
called amyloid plaques.
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stvarajući ljepljive nakupine
nazvane amiloidni plakovi.
nazvane amiloidni plakovi.
02:53
How many people here
are 40 years old or older?
are 40 years old or older?
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Koliko ljudi ovdje ima 40 godina ili više?
02:57
You're afraid to admit it now.
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Bojite se to sada priznati.
02:59
This initial step into the disease,
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Taj početni korak u bolesti,
03:01
this presence of amyloid
plaques accumulating,
plaques accumulating,
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to prisustvo amiloidnih plakova
koji se nakupljaju
koji se nakupljaju
03:05
can already be found in your brains.
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već može biti u vašem mozgu.
03:08
The only way we could be sure of this
would be through a PET scan,
would be through a PET scan,
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Jedini način da budemo sigurno u to
bio bi putem PET pretrage,
bio bi putem PET pretrage,
03:11
because at this point,
you are blissfully unaware.
you are blissfully unaware.
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jer u ovom trenutku,
vi ste posve nesvjesni toga.
vi ste posve nesvjesni toga.
03:15
You're not showing any impairments
in memory, language, or cognition ...
in memory, language, or cognition ...
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Ne pokazujete nikakva oštećenja
u pamćenju, jeziku ili spoznaji...
u pamćenju, jeziku ili spoznaji...
03:19
yet.
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još.
03:21
We think it takes at least 15 to 20 years
of amyloid plaque accumulation
of amyloid plaque accumulation
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Mislimo da je potrebno najmanje 15 do 20
godina nakupljanja amiloidnog plaka
godina nakupljanja amiloidnog plaka
03:26
before it reaches a tipping point,
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prije negoli on dosegne prijelomnu točku,
03:28
then triggering a molecular cascade
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aktivirajući tada molekularni niz
03:30
that causes the clinical
symptoms of the disease.
symptoms of the disease.
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koji uzrokuje kliničke simptome bolesti.
03:33
Prior to the tipping point,
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Prije te prekretnice,
03:35
your lapses in memory
might include things like,
might include things like,
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gubici u vašoj memoriji
mogu uključivati stvari poput
mogu uključivati stvari poput
03:39
"Why did I come in this room?"
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"Zašto sam došao/došla u ovu prostoriju?"
03:41
or "Oh ... what's his name?"
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ili "Oh... kako se on zove?"
03:44
or "Where did I put my keys?"
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ili "Kamo sam stavio/stavila ključeve?"
03:47
Now, before you all
start freaking out again,
start freaking out again,
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Prije negoli svi ponovno
počnete paničariti,
počnete paničariti,
03:50
because I know half of you did at least
one of those in the last 24 hours --
one of those in the last 24 hours --
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jer znam da je polovina vas učinila
bar jedno od ovoga u zadnja 24 sata...
bar jedno od ovoga u zadnja 24 sata...
03:55
these are all normal kinds of forgetting.
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ovo su sve normalni oblici zaboravljanja.
03:58
In fact, I would argue that these examples
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Zapravo, rekla bih da ovi primjeri
04:01
might not even involve your memory,
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ne moraju čak ni uključivati
vašu memoriju,
vašu memoriju,
04:03
because you didn't pay attention
to where you put your keys
to where you put your keys
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jer niste obraćali pažnju na to
gdje ste ostavili ključeve
gdje ste ostavili ključeve
04:06
in the first place.
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na početku.
04:07
After the tipping point,
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Nakon prijelomne točke,
04:09
the glitches in memory,
language and cognition are different.
language and cognition are different.
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zastoji u memoriji, jeziku
i spoznaji su različiti.
i spoznaji su različiti.
04:12
Instead of eventually finding
your keys in your coat pocket
your keys in your coat pocket
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Umjesto da kasnije nađete ključeve
u džepu svog kaputa,
u džepu svog kaputa,
04:15
or on the table by the door,
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ili na stoliću pored vrata,
04:17
you find them in the refrigerator,
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nađete ih u hladnjaku,
04:20
or you find them and you think,
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ili ih nađete i pomislite
04:22
"What are these for?"
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"Čemu ovo služi?"
04:24
So what happens when amyloid plaques
accumulate to this tipping point?
accumulate to this tipping point?
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Što se, dakle, događa kada se amiloidni
plakovi nakupe do te prijelomne točke?
plakovi nakupe do te prijelomne točke?
04:30
Our microglia janitor cells
become hyper-activated,
become hyper-activated,
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Naše mikroglija stanice, čistači,
postaju prekomjerno aktivne,
postaju prekomjerno aktivne,
04:33
releasing chemicals that cause
inflammation and cellular damage.
inflammation and cellular damage.
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otpuštajući tvari koje uzokuju
upalu i stanično oštećenje.
upalu i stanično oštećenje.
04:37
We think they might actually
start clearing away
start clearing away
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Mislimo da možda počinju sa čišćenjem
04:40
the synapses themselves.
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i samih sinapsi.
04:42
A crucial neural transport protein
called "tau" becomes hyperphosphorylated
called "tau" becomes hyperphosphorylated
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Protein ključan za neuronski prijenos,
zvan 'tau', postaje hiperfosforiliran
zvan 'tau', postaje hiperfosforiliran
04:46
and twists itself
into something called "tangles,"
into something called "tangles,"
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i uvija se u nešto slično spirali,
čvorovima,
čvorovima,
04:49
which choke off the neurons
from the inside.
from the inside.
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što pritišće neurone iznutra.
04:52
By mid-stage Alzheimer's,
we have massive inflammation and tangles
we have massive inflammation and tangles
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U srednjoj fazi Alzheimera
imamo brojne upale i čvorove,
imamo brojne upale i čvorove,
04:56
and all-out war at the synapse
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sveobuhvatni rat na sinapsi
04:58
and cell death.
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te odumiranje stanice.
05:00
So if you were a scientist
trying to cure this disease,
trying to cure this disease,
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Dakle, ako biste bili znanstvenik
koji pokušava izliječiti ovu bolest,
koji pokušava izliječiti ovu bolest,
05:03
at what point would you ideally
want to intervene?
want to intervene?
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na kojem točno dijelu biste intervenirali?
05:07
Many scientists are betting big
on the simplest solution:
on the simplest solution:
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Mnogi znanstvenici klade se
u najjednostavnije rješenje:
u najjednostavnije rješenje:
05:11
keep amyloid plaques
from reaching that tipping point,
from reaching that tipping point,
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spriječiti amiloidne plakove
da dosegnu prijelomnu točku,
da dosegnu prijelomnu točku,
05:14
which means that drug discovery is largely
focused on developing a compound
focused on developing a compound
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što znači da je pronalazak lijeka
najviše fokusiran na razvoj sastojka
najviše fokusiran na razvoj sastojka
05:18
that will prevent, eliminate, or reduce
amyloid plaque accumulation.
amyloid plaque accumulation.
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koji će spriječiti, odstraniti ili
smanjiti nakupljanje amiloidnog plaka.
smanjiti nakupljanje amiloidnog plaka.
05:24
So the cure for Alzheimer's will likely be
a preventative medicine.
a preventative medicine.
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Stoga će lijek za Alzheimerovu bolest
vjerojatno biti preventivna medicina.
vjerojatno biti preventivna medicina.
05:30
We're going to have to take this pill
before we reach that tipping point,
before we reach that tipping point,
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Morat ćemo uzeti tabletu
prije nego dosegnemo tu prijelomnu točku,
prije nego dosegnemo tu prijelomnu točku,
05:33
before the cascade is triggered,
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prije nego se molekularni niz aktivira,
05:35
before we start leaving
our keys in the refrigerator.
our keys in the refrigerator.
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prije negoli počnemo ostavljati
svoje ključeve u hladnjaku.
svoje ključeve u hladnjaku.
05:39
We think this is why, to date,
these kinds of drugs have failed
these kinds of drugs have failed
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Mislimo da zbog toga, do danas,
ovakvi lijekovi nisu učinkoviti
ovakvi lijekovi nisu učinkoviti
05:43
in clinical trials --
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u kliničkim pokusima,
05:44
not because the science wasn't sound,
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ne zato što znanost nije na dobrom putu,
05:46
but because the people in these trials
were already symptomatic.
were already symptomatic.
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već stoga što su ljudi u tim pokusima
već imali simptome.
već imali simptome.
05:50
It was too late.
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Bilo je prekasno.
05:52
Think of amyloid plaques as a lit match.
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Zamislite amiloidni plak kao šibicu.
05:55
At the tipping point, the match
sets fire to the forest.
sets fire to the forest.
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Na prijelomnoj točki,
šibica prouzrokuje požar u šumi.
šibica prouzrokuje požar u šumi.
05:59
Once the forest is ablaze,
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Jednom kada je šuma u plamenu,
06:01
it doesn't do any good
to blow out the match.
to blow out the match.
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nema nikakve koristi od gašenja šibice.
06:04
You have to blow out the match
before the forest catches fire.
before the forest catches fire.
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Šibicu moraš ugasiti
prije negoli šuma počne gorjeti.
prije negoli šuma počne gorjeti.
06:08
Even before scientists sort this out,
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Čak i prije negoli znanstvenici
ovo riješe,
ovo riješe,
06:10
this information is actually
really good news for us,
really good news for us,
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ova informacija je zapravo
vrlo dobra vijest za nas,
vrlo dobra vijest za nas,
06:13
because it turns out that the way we live
can influence the accumulation
can influence the accumulation
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jer se ispostavlja da način na koji živimo
može utjecati na nakupljanje
može utjecati na nakupljanje
06:17
of amyloid plaques.
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amiloidnih plakova.
06:18
And so there are things we can do
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I stoga možemo nešto učiniti
06:20
to keep us from reaching
that tipping point.
that tipping point.
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kako ne bismo dosegnuli
tu prijelomnu točku.
tu prijelomnu točku.
06:23
Let's picture your risk
of Alzheimer's as a see-saw scale.
of Alzheimer's as a see-saw scale.
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Predočimo vaš rizik od Alzheimera
kao na klackalici.
kao na klackalici.
06:27
We're going to pile
risk factors on one arm,
risk factors on one arm,
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Na jednoj ruci skupljat ćemo
rizične čimbenike,
rizične čimbenike,
06:29
and when that arm hits the floor,
you are symptomatic
you are symptomatic
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i kada ta ruka udari u pod,
imate simptome
imate simptome
06:31
and diagnosed with Alzheimer's.
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i dijagnozu Alzheimerove bolesti.
06:34
Let's imagine you're 50 years old.
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Zamislimo da imate 50 godina.
06:36
You're not a spring chicken anymore,
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Niste više u cvijetu mladosti,
06:38
so you've accumulated
some amyloid plaques with age.
some amyloid plaques with age.
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i s godinama ste nakupili
određenu količinu amiloidnih plakova.
određenu količinu amiloidnih plakova.
06:41
Your scale is tipped a little bit.
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Vaša klackalica se malo nagnula.
06:44
Now let's look at your DNA.
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Pogledajmo sada vašu DNK.
06:46
We've all inherited our genes
from our moms and our dads.
from our moms and our dads.
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Svi smo mi naslijedili gene
od svojih majki i očeva.
od svojih majki i očeva.
06:50
Some of these genes will increase our risk
and some will decrease it.
and some will decrease it.
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Neki od tih gena povećat će naš rizik,
a neki smanjiti.
a neki smanjiti.
06:54
If you're like Alice in "Still Alice,"
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Ako ste poput Alice u filmu
'I dalje Alice',
'I dalje Alice',
06:56
you've inherited a rare genetic mutation
that cranks out amyloid beta,
that cranks out amyloid beta,
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naslijedili ste rijetku genetsku mutaciju
koja proizvodi beta amiloid
koja proizvodi beta amiloid
07:01
and this alone will tip
your scale arm to the ground.
your scale arm to the ground.
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i samo to će već nagnuti
vašu klackalicu do poda.
vašu klackalicu do poda.
07:04
But for most of us, the genes we inherit
will only tip the arm a bit.
will only tip the arm a bit.
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No za većinu nas, geni koje nasljeđujemo
samo će malo nagnuti ruku na tu stranu.
samo će malo nagnuti ruku na tu stranu.
07:08
For example, APOE4 is a gene variant
that increases amyloid,
that increases amyloid,
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Na primjer, APOE4 je varijanta gena
koja povećava amiloid,
koja povećava amiloid,
07:13
but you can inherit a copy of APOE4
from mom and dad
from mom and dad
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no možete naslijediti APOE4
od mame ili tate,
od mame ili tate,
07:16
and still never get Alzheimer's,
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a ipak ne dobiti Alzheimera,
07:19
which means that for most of us,
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što znači da za većinu nas,
07:21
our DNA alone does not determine
whether we get Alzheimer's.
whether we get Alzheimer's.
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sama naša DNK ne određuje
hoćemo li dobiti Alzheimera.
hoćemo li dobiti Alzheimera.
07:25
So what does?
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Što onda određuje?
07:27
We can't do anything about getting older
or the genes we've inherited.
or the genes we've inherited.
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Ne možemo ništa učiniti u vezi starenja,
ili gena koje nasljeđujemo.
ili gena koje nasljeđujemo.
07:31
So far, we haven't changed
our brain's destiny.
our brain's destiny.
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Za sada nismo izmijenili sudbinu
našeg mozga.
našeg mozga.
07:35
What about sleep?
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Što je sa spavanjem?
07:37
In slow-wave deep sleep, our glial cells
rinse cerebral spinal fluid
rinse cerebral spinal fluid
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Kod sporih valova u dubokom snu,
naše glijalne stanice
naše glijalne stanice
07:41
throughout our brains,
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čiste cerebralnu spinalnu tekućinu
po čitavom mozgu
po čitavom mozgu
07:42
clearing away metabolic waste
that accumulated in our synapses
that accumulated in our synapses
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odstranjujući metabolički otpad
koji se nakupljao u našim sinapsama
koji se nakupljao u našim sinapsama
07:46
while we were awake.
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dok smo bili budni.
07:48
Deep sleep is like
a power cleanse for the brain.
a power cleanse for the brain.
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Duboki san je za mozak
poput moćnog čistača.
poput moćnog čistača.
07:51
But what happens if you shortchange
yourself on sleep?
yourself on sleep?
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No, što se događa
ako si uskraćujete san?
ako si uskraćujete san?
07:55
Many scientists believe
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Mnogi znanstvenici vjeruju
07:56
that poor sleep hygiene might actually
be a predictor of Alzheimer's.
be a predictor of Alzheimer's.
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da loša higijena spavanja zapravo
može predskazati Alzheimera.
može predskazati Alzheimera.
08:01
A single night of sleep deprivation
leads to an increase in amyloid beta.
leads to an increase in amyloid beta.
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Samo jedna noć uskraćivanja sna
dovodi do povećanja beta amiloida.
dovodi do povećanja beta amiloida.
08:07
And amyloid accumulation
has been shown to disrupt sleep,
has been shown to disrupt sleep,
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A pokazalo se kako
nakupljanje amiloida ometa spavanje,
nakupljanje amiloida ometa spavanje,
08:10
which in turn causes
more amyloid to accumulate.
more amyloid to accumulate.
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što zauzvrat uzrokuje
više amiloida koji se može nakupljati.
više amiloida koji se može nakupljati.
08:13
And so now we have
this positive feedback loop
this positive feedback loop
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I tako sada imamo
tu pozitivnu povratnu vezu
tu pozitivnu povratnu vezu
08:15
that's going to accelerate
the tipping of that scale.
the tipping of that scale.
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koja će ubrzati prevagu.
08:19
What else?
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Što još?
08:20
Cardiovascular health.
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Zdravlje srca i krvnih žila.
08:23
High blood pressure, diabetes,
obesity, smoking, high cholesterol,
obesity, smoking, high cholesterol,
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Visoki krvni tlak, dijabetes,
pretilost, pušenje, visoki kolesterol,
pretilost, pušenje, visoki kolesterol,
08:26
have all been shown to increase our risk
of developing Alzheimer's.
of developing Alzheimer's.
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svi su ukazali na povećanje našeg rizika
od razvoja Alzheimera.
od razvoja Alzheimera.
08:30
Some autopsy studies have shown
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Neke studije s obdukcija pokazale su
08:32
that as many as 80 percent
of people with Alzheimer's
of people with Alzheimer's
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da čak 80% ljudi koji su bolovali
od Alzheimera,
od Alzheimera,
08:35
also had cardiovascular disease.
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imali su i neku bolest krvožilnog sustava.
08:38
Aerobic exercise has been shown
in many studies to decrease amyloid beta
in many studies to decrease amyloid beta
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Aerobna vježba pokazala se u mnogim
studijama da smanjuje beta amiloid
studijama da smanjuje beta amiloid
08:43
in animal models of the disease.
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na životinjskim modelima bolesti.
08:45
So a heart-healthy
Mediterranean lifestyle and diet
Mediterranean lifestyle and diet
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Dakle, mediteranski način života
i prehrane, dobar za srce
i prehrane, dobar za srce
08:49
can help to counter
the tipping of this scale.
the tipping of this scale.
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može pomoći i prevagnuti
na suprotnu stranu.
na suprotnu stranu.
08:52
So there are many things we can do
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Dakle, ima mnogo toga što možemo učiniti
08:55
to prevent or delay
the onset of Alzheimer's.
the onset of Alzheimer's.
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da spriječimo ili odgodimo
početak Alzheimera.
početak Alzheimera.
08:57
But let's say
you haven't done any of them.
you haven't done any of them.
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No, recimo da niste učinili ništa od toga.
09:00
Let's say you're 65;
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Pretpostavimo da imate 65 godina;
09:02
there's Alzheimer's in your family,
so you've likely inherited a gene or two
so you've likely inherited a gene or two
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Alzheimerova bolest postoji u vašoj obitelji,
i vjerojatno ste naslijedili koji gen,
i vjerojatno ste naslijedili koji gen,
09:06
that tips your scale arm a bit;
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što čini malu prevagu na ovu stranu
09:08
you've been burning the candle
at both ends for years;
at both ends for years;
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Godinama ste se naprezali,
09:11
you love bacon;
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volite slaninu,
09:12
and you don't run unless
someone's chasing you.
someone's chasing you.
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i ne trčite osim
ako vas netko ne lovi.
ako vas netko ne lovi.
09:14
(Laughter)
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(Smijeh)
09:16
Let's imagine that your amyloid plaques
have reached that tipping point.
have reached that tipping point.
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Zamislimo da su vaši amiloidni plakovi
dosegnuli prijelomnu točku.
dosegnuli prijelomnu točku.
09:19
Your scale arm has crashed to the floor.
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Vaša ruka prevagom je tresnula o pod,
09:21
You've tripped the cascade,
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aktivirali ste molekularni niz,
09:23
setting fire to the forest,
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zapalili vatru u šumi,
09:25
causing inflammation, tangles,
and cell death.
and cell death.
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što je dovelo do izgaranja, čvorova
te odumiranja stanica.
te odumiranja stanica.
09:29
You should be symptomatic for Alzheimer's.
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Trebali biste imati simptome Alzheimera.
09:31
You should be having trouble
finding words and keys
finding words and keys
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Trebalo bi vam biti teško
pronaći ispravnu riječ, ključeve,
pronaći ispravnu riječ, ključeve,
09:35
and remembering what I said
at the beginning of this talk.
at the beginning of this talk.
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ili zapamtiti što sam rekla
na početku ovog govora.
na početku ovog govora.
09:38
But you might not be.
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No, možda i nije.
09:41
There's one more thing you can do
to protect yourself
to protect yourself
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Ima još nešto što možete učiniti
kako biste se zaštitili
kako biste se zaštitili
09:43
from experiencing
the symptoms of Alzheimer's,
the symptoms of Alzheimer's,
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od proživljavanja simptoma Alzheimera,
09:46
even if you have the full-blown disease
pathology ablaze in your brain.
pathology ablaze in your brain.
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čak i ako u svom mozgu imate
patologiju bolesti u punom zamahu.
patologiju bolesti u punom zamahu.
09:50
It has to do with neural plasticity
and cognitive reserve.
and cognitive reserve.
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To je vezano za neuralnu plastičnost
i kognitivne rezerve.
i kognitivne rezerve.
09:55
Remember, the experience
of having Alzheimer's
of having Alzheimer's
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Zapamtite, iskustvo koje imate
bolujući od Alzheimera
bolujući od Alzheimera
09:57
is ultimately a result of losing synapses.
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rezultat je gubitka sinapsi.
10:01
The average brain has
over a hundred trillion synapses,
over a hundred trillion synapses,
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Prosječan mozak ima
preko stotinu trilijuna sinapsi,
preko stotinu trilijuna sinapsi,
10:04
which is fantastic;
we've got a lot to work with.
we've got a lot to work with.
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što je fantastično, imamo mnogo toga
s čime možemo raditi.
s čime možemo raditi.
10:07
And this isn't a static number.
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I to nije samo statičan broj.
10:09
We gain and lose synapses all the time,
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Mi neprestano stječemo i gubimo sinapse,
10:11
through a process
called neural plasticity.
called neural plasticity.
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kroz proces koji se zove
neuralna plastičnost.
neuralna plastičnost.
10:14
Every time we learn something new,
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Svaki puta kada naučimo nešto novo,
10:16
we are creating and strengthening
new neural connections,
new neural connections,
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stvaramo i jačamo nove neuralne veze,
10:20
new synapses.
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nove sinapse.
10:22
In the Nun Study,
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U jednoj studiji o redovnicama,
10:24
678 nuns, all over the age of 75
when the study began,
when the study began,
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njih 678, sve su bile stare
preko 75 godina kada je studija počela,
preko 75 godina kada je studija počela,
10:29
were followed for more than two decades.
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i promatrane su preko dva desetljeća.
10:31
They were regularly given
physical checkups and cognitive tests,
physical checkups and cognitive tests,
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Redovito su bile podvrgnute sistematskim
pregledima i kognitivnim testovima,
pregledima i kognitivnim testovima,
10:35
and when they died, their brains
were all donated for autopsy.
were all donated for autopsy.
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i kada su umrle, mozgovi svih njih
bili su donirani za potrebe obdukcije.
bili su donirani za potrebe obdukcije.
10:39
In some of these brains, scientists
discovered something surprising.
discovered something surprising.
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U nekim od tih mozgova, znanstvenici su
otkrili nešto iznenađujuće.
otkrili nešto iznenađujuće.
10:43
Despite the presence of plaques
and tangles and brain shrinkage --
and tangles and brain shrinkage --
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Unatoč postojanju plakova, čvorova,
te smanjivanju mozga,
te smanjivanju mozga,
10:48
what appeared to be
unquestionable Alzheimer's --
unquestionable Alzheimer's --
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što je neupitno ukazivalo na Alzheimera,
10:51
the nuns who had belonged
to these brains showed no signs
to these brains showed no signs
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mozgovi tih redovnica
nisu pokazivali znakove
nisu pokazivali znakove
10:54
of having the disease
while they were alive.
while they were alive.
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postojanja bolesti dok su bile žive.
10:58
How can this be?
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Kako je to moguće?
11:00
We think it's because these nuns
had a high level of cognitive reserve,
had a high level of cognitive reserve,
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Mislimo da je to stoga što su imale
visoki stupanj kognitivne rezerve,
visoki stupanj kognitivne rezerve,
11:04
which is a way of saying that they had
more functional synapses.
more functional synapses.
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što bi značilo da su imale
funkcionalnije sinapse.
funkcionalnije sinapse.
11:08
People who have more years
of formal education,
of formal education,
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Osobe koje imaju više godina
formalnog obrazovanja,
formalnog obrazovanja,
11:10
who have a high degree of literacy,
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koje imaju visok stupanj pismenosti,
11:12
who engage regularly
in mentally stimulating activities,
in mentally stimulating activities,
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koje su redovito zaokupljene
mentalno stimulativnim aktivnostima,
mentalno stimulativnim aktivnostima,
11:16
all have more cognitive reserve.
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sve te osobe imaju
veće kognitivne rezerve.
veće kognitivne rezerve.
11:19
They have an abundance
and a redundancy in neural connections.
and a redundancy in neural connections.
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One imaju obilje i višak neuralnih veza.
11:23
So even if they have a disease
like Alzheimer's
like Alzheimer's
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Pa čak i ako imaju bolest
poput Alzheimera,
poput Alzheimera,
11:25
compromising some of their synapses,
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koja ugrožava neke od njihovih sinapsi,
11:28
they've got many extra backup connections,
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one imaju i još mnogo
dodatnih rezervnih veza,
dodatnih rezervnih veza,
11:31
and this buffers them from noticing
that anything is amiss.
that anything is amiss.
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koje ublažavaju dojam
da nešto nije u redu.
da nešto nije u redu.
11:34
Let's imagine a simplified example.
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Zamislimo pojednostavljeni primjer.
11:37
Let's say you only know one thing
about a subject.
about a subject.
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Recimo da znate samo
jedan podatak o nekoj temi.
jedan podatak o nekoj temi.
11:40
Let's say it's about me.
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Recimo da se radi o meni.
11:41
You know that Lisa Genova
wrote "Still Alice,"
wrote "Still Alice,"
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Znate da je Lisa Genova
napisala 'I dalje Alice',
napisala 'I dalje Alice',
11:43
and that's the only thing
you know about me.
you know about me.
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i to je jedino što znate o meni.
11:46
You have that single neural connection,
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Imate tu jedinu neuralnu vezu,
11:48
that one synapse.
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tu jednu sinapsu.
11:50
Now imagine you have Alzheimer's.
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Sada zamislite da bolujete od Alzheimera.
11:52
You have plaques and tangles
and inflammation
and inflammation
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Imate plakove, čvorove i upale
11:55
and microglia devouring that synapse.
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te mikrogliju koja guta tu sinapsu.
11:58
Now when someone asks you,
"Hey, who wrote 'Still Alice?'"
"Hey, who wrote 'Still Alice?'"
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I sada, kada vas netko pita,
"Hej, tko je napisao 'I dalje Alice?'"
"Hej, tko je napisao 'I dalje Alice?'"
12:02
you can't remember,
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vi se ne možete sjetiti,
12:04
because that synapse
is either failing or gone.
is either failing or gone.
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jer je ta sinapsa
ili zakazala ili odumrla.
ili zakazala ili odumrla.
12:07
You've forgotten me forever.
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Zauvijek ste me zaboravili.
12:09
But what if you had learned more about me?
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Ali što ako ste o meni znali nešto više?
12:12
Let's say you learned
four things about me.
four things about me.
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Recimo da ste naučili
četiri stvari o meni.
četiri stvari o meni.
12:14
Now imagine you have Alzheimer's,
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Sada zamislite da bolujete od Alzheimera,
12:16
and three of those synapses
are damaged or destroyed.
are damaged or destroyed.
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i tri od tih sinapsi su
oštećene ili uništene.
oštećene ili uništene.
12:20
You still have a way
to detour the wreckage.
to detour the wreckage.
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I dalje imate način da zaobiđete prepreku.
12:22
You can still remember my name.
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2019
I dalje se sjećate mog imena.
12:25
So we can be resilient
to the presence of Alzheimer's pathology
to the presence of Alzheimer's pathology
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Znači, možemo biti prilagodljivi
na prisustvo patologije Alzheimera
na prisustvo patologije Alzheimera
12:29
through the recruitment
of yet-undamaged pathways.
of yet-undamaged pathways.
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aktiviranjem još neoštećenih puteva.
12:32
And we create these pathways,
this cognitive reserve,
this cognitive reserve,
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I mi stvaramo te puteve,
te kognitivne rezerve,
te kognitivne rezerve,
12:36
by learning new things.
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kada učimo nove stvari.
12:38
Ideally, we want these new things
to be as rich in meaning as possible,
to be as rich in meaning as possible,
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U idealnom slučaju, želimo da te
nove stvari budu što bogatije značenjem,
nove stvari budu što bogatije značenjem,
12:43
recruiting sight and sound
and associations and emotion.
and associations and emotion.
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aktivirajući vid, zvuk,
asocijacije i emocije.
asocijacije i emocije.
12:48
So this really doesn't mean
doing crossword puzzles.
doing crossword puzzles.
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Dakle, to zaista ne znači
rješavanje križaljki.
rješavanje križaljki.
12:51
You don't want to simply retrieve
information you've already learned,
information you've already learned,
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Ne želite samo izvlačiti informacije
koje ste već naučili,
koje ste već naučili,
12:55
because this is like traveling
down old, familiar streets,
down old, familiar streets,
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jer to je poput vožnje
starim, poznatim cestama,
starim, poznatim cestama,
12:59
cruising neighborhoods you already know.
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kružeći četvrtima koja već poznajete.
13:02
You want to pave new neural roads.
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Vi želite stvoriti nove neuralne puteve,
13:04
Building an Alzheimer's-resistant brain
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stvarati mozak koji će biti
otporan na Alzheimera
otporan na Alzheimera
13:07
means learning to speak Italian,
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znači naučiti govoriti talijanski,
13:09
meeting new friends,
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steći nove prijatelje,
13:11
reading a book,
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pročitati knjigu,
13:12
or listening to a great TED Talk.
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ili odslušati neki odličan TED govor.
13:15
And if, despite all of this, you are
someday diagnosed with Alzheimer's,
someday diagnosed with Alzheimer's,
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I ako unatoč svemu ovome, jednog dana
dobijete dijagnozu Alzheimera,
dobijete dijagnozu Alzheimera,
13:20
there are three lessons I've learned
from my grandmother
from my grandmother
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tri su lekcije koje sam naučila
od svoje bake
od svoje bake
13:23
and the dozens of people I've come to know
living with this disease.
living with this disease.
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i deseci ljudi koje sam upoznala
i koji žive s ovom bolešću.
i koji žive s ovom bolešću.
13:28
Diagnosis doesn't mean
you're dying tomorrow.
you're dying tomorrow.
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Dijagnoza ne znači
da ćete sutra umrijeti.
da ćete sutra umrijeti.
13:31
Keep living.
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Nastavite živjeti.
13:33
You won't lose your emotional memory.
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Nećete izgubiti
svoju emocionalnu memoriju.
svoju emocionalnu memoriju.
13:35
You'll still be able
to understand love and joy.
to understand love and joy.
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I dalje ćete moći razumjeti
ljubav i radost.
ljubav i radost.
13:38
You might not remember
what I said five minutes ago,
what I said five minutes ago,
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Možda se nećete sjećati
što sam rekla prije pet minuta,
što sam rekla prije pet minuta,
13:42
but you'll remember how I made you feel.
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ali ćete se sjećati kakav osjećaj
sam izazvala u vama.
sam izazvala u vama.
13:44
And you are more than what
you can remember.
you can remember.
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I vi ste mnogo više
od onoga čega se možete sjetiti.
od onoga čega se možete sjetiti.
13:48
Thank you.
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Hvala vam.
13:49
(Applause)
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(Pljesak)
ABOUT THE SPEAKER
Lisa Genova - Neuroscientist, novelistThrough her fiction, Lisa Genova beckons us into the lives of people with neurological disease, making their worlds real and relatable.
Why you should listen
Lisa Genova wields her ability to tell a story and her knowledge of the human brain to talk about medical conditions like Alzheimer’s in warmly human terms. Her writing, often focusing on those who are misunderstood, explores the lives of people living with neurological diseases and disorders. A bestselling author, her work has been transformed into an Oscar-winning film, Still Alice, but the real triumph is Genova’s ability to help us empathize with a person’s journey we otherwise couldn’t even begin to understand.
Her newest book, Inside the O’Briens, is about Huntington’s disease.
Lisa Genova | Speaker | TED.com