TED2017
Lisa Genova: What you can do to prevent Alzheimer's
丽莎·吉诺瓦: 预防老年痴呆症的方法
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”老年痴呆并不一定是你大脑的宿命。“神经科学家及《依然爱丽丝》的作者丽莎·吉诺瓦如此说道。她还分享了最新的科学研究和一些我们能够如何能够锻炼一个抵抗老年痴呆症大脑的研究。
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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在座有多少人希望能活到八十岁以上？
00:18
Yeah.
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好。
00:19
I think we all have
this hopeful expectation
this hopeful expectation
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我想我们每个人
都渴望能够长寿。
00:22
of living into old age.
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00:24
Let's project out into the future,
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让我们穿越到未来，
00:26
to your future "you's,"
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未来的你们
00:28
and let's imagine that we're all 85.
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假设都已85岁。
00:31
Now, everyone look at two people.
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我们随便挑选两个人，
00:35
One of you probably has
Alzheimer's disease.
Alzheimer's disease.
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其中一人就可能患有老年痴呆症。
00:39
(Laughter)
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（笑声）
00:42
Alright, alright.
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好吧，好吧。
00:44
And maybe you're thinking,
"Well, it won't be me."
"Well, it won't be me."
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也许你会想：“反正不会是我”。
00:49
Then, OK. You are a caregiver.
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那么好的。你是另一位的照顾人。
00:53
So --
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所以……
00:54
(Laughter)
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（笑声）
00:57
so in some way,
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所以某种意义上来说，
00:58
this terrifying disease
is likely to affect us all.
is likely to affect us all.
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这个可怕的疾病可能
会影响我们每一个人。
会影响我们每一个人。
01:02
Part of the fear around Alzheimer's
stems from the sense
stems from the sense
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对于老年痴呆的恐惧部分源于
01:05
that there's nothing we can do about it.
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我们对此的无能为力。
01:08
Despite decades of research, we still
have no disease-modifying treatment
have no disease-modifying treatment
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尽管几十年的研究下来，
我们依然没有改善病情的方法。
01:13
and no cure.
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01:15
So if we're lucky enough
to live long enough,
to live long enough,
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如果我们有幸长命百岁，
01:17
Alzheimer's appears to be
our brain's destiny.
our brain's destiny.
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老年痴呆似乎是我们大脑的宿命。
01:21
But maybe it doesn't have to be.
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情况也许没有这么糟。
01:23
What if I told you we could
change these statistics,
change these statistics,
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如果我告诉你，我们可以改变现状，
01:26
literally change our brain's destiny,
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就是改变我们大脑的命运，
01:29
without relying on a cure
or advancements in medicine?
or advancements in medicine?
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不依赖于任何疗法或是药物的发展呢？
01:33
Let's begin by looking at
what we currently understand
what we currently understand
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让我们先看看目前
01:36
about the neuroscience of Alzheimer's.
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神经学上对老年痴呆的了解。
01:39
Here's a picture
of two neurons connecting.
of two neurons connecting.
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这是一张两个神经元连接的图。
01:42
The point of connection,
this space circled in red,
this space circled in red,
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连接的部位，也就是红色圈出的这块，
01:46
is called the synapse.
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叫做突触。
01:47
The synapse is where
neurotransmitters are released.
neurotransmitters are released.
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突触是神经递质释放的场所，
01:51
This is where signals are transmitted,
where communication happens.
where communication happens.
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这是信号传送、交流的场所。
01:55
This is where we think,
feel, see, hear, desire ...
feel, see, hear, desire ...
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这是我们思考、感受、视听、欲望
02:00
and remember.
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和记忆的场所。
02:02
And the synapse
is where Alzheimer's happens.
is where Alzheimer's happens.
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而突触也正是老年痴呆发病的地方。
02:05
Let's zoom in on the synapse
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让我们把突触放大，
02:07
and look at a cartoon representation
of what's going on.
of what's going on.
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看一则动画演示。
02:10
During the business
of communicating information,
of communicating information,
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在信息沟通的过程中，
02:13
in addition to releasing neurotransmitters
like glutamate into the synapse,
like glutamate into the synapse,
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除了释放谷氨酸等神经递质到突触，
02:17
neurons also release a small peptide
called amyloid beta.
called amyloid beta.
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神经元还释放了一种
名为β淀粉样蛋白的小肽。
名为β淀粉样蛋白的小肽。
02:22
Normally, amyloid beta is cleared away
metabolized by microglia,
metabolized by microglia,
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正常情况下，β淀粉样蛋白
在新陈代谢时会被清除，
在新陈代谢时会被清除，
由我们大脑的看护细胞
小神经胶质细胞处理。
小神经胶质细胞处理。
02:27
the janitor cells of our brains.
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02:30
While the molecular causes
of Alzheimer's are still debated,
of Alzheimer's are still debated,
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尽管分子层面引发
老年痴呆的原因还争论不休，
老年痴呆的原因还争论不休，
02:34
most neuroscientists believe
that the disease begins
that the disease begins
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大多数神经学家相信
β淀粉样蛋白的累积引发了老年痴呆。
02:37
when amyloid beta begins to accumulate.
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02:40
Too much is released,
or not enough is cleared away,
or not enough is cleared away,
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释放了太多，或者是未能完全清理，
02:43
and the synapse begins
to pile up with amyloid beta.
to pile up with amyloid beta.
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突触因此便开始堆积β淀粉样蛋白。
02:47
And when this happens, it binds to itself,
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若这一事件发生
突触逐渐束缚了自己，
突触逐渐束缚了自己，
02:49
forming sticky aggregates
called amyloid plaques.
called amyloid plaques.
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产生一种叫做淀粉样斑块
的黏糊糊的聚合体。
的黏糊糊的聚合体。
02:53
How many people here
are 40 years old or older?
are 40 years old or older?
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在座的有多少人已经四十多岁了？
02:57
You're afraid to admit it now.
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你不想承认了吗？
02:59
This initial step into the disease,
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老年痴呆症的起步，
03:01
this presence of amyloid
plaques accumulating,
plaques accumulating,
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淀粉样斑块的累积，
03:05
can already be found in your brains.
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也许已经在你的大脑初步产生。
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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我们唯一能确认的方式是PET扫描，
03:11
because at this point,
you are blissfully unaware.
you are blissfully unaware.
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因为现在你对此毫无知觉。
03:15
You're not showing any impairments
in memory, language, or cognition ...
in memory, language, or cognition ...
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你还没有任何记忆、
语言、或是认知方面的问题...
语言、或是认知方面的问题...
03:19
yet.
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现在还没有。
03:21
We think it takes at least 15 to 20 years
of amyloid plaque accumulation
of amyloid plaque accumulation
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我们认为淀粉样斑块的累积
至少需要15至20年时间
至少需要15至20年时间
03:26
before it reaches a tipping point,
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才会到达它的临界点，
03:28
then triggering a molecular cascade
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随后引发分子的连锁反应
03:30
that causes the clinical
symptoms of the disease.
symptoms of the disease.
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导致了这一疾病的临床症状。
03:33
Prior to the tipping point,
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在这一临界点之前，
03:35
your lapses in memory
might include things like,
might include things like,
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你的记忆衰退可能会像这样：
03:39
"Why did I come in this room?"
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“我为什么到这间屋子来？”
03:41
or "Oh ... what's his name?"
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或是“呃，他叫什么来着？”
03:44
or "Where did I put my keys?"
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或是“我把钥匙放哪了？”
03:47
Now, before you all
start freaking out again,
start freaking out again,
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现在，在你们惊慌失措之前，
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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我知道你们中的半数在过去的
24小时内至少有过上述之一，
24小时内至少有过上述之一，
03:55
these are all normal kinds of forgetting.
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这些都是正常的遗忘类型。
03:58
In fact, I would argue that these examples
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实际上，我的看法是这些示例，
04:01
might not even involve your memory,
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甚至都与你的记忆没什么关系，
04:03
because you didn't pay attention
to where you put your keys
to where you put your keys
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因为起初你并没有在意
你把钥匙放在哪里。
你把钥匙放在哪里。
04:06
in the first place.
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04:07
After the tipping point,
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在临界点之后，
04:09
the glitches in memory,
language and cognition are different.
language and cognition are different.
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记忆、语言和认知的偏差是不一样的。
04:12
Instead of eventually finding
your keys in your coat pocket
your keys in your coat pocket
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最后发现钥匙并不在你的大衣口袋，
04:15
or on the table by the door,
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或是不在门边的桌上，
04:17
you find them in the refrigerator,
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你在冰箱里找到了你的钥匙，
04:20
or you find them and you think,
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或者你找到钥匙后想，
04:22
"What are these for?"
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“这玩意是干嘛的？”
04:24
So what happens when amyloid plaques
accumulate to this tipping point?
accumulate to this tipping point?
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所以当淀粉样斑块积累到
临界点后会发生什么？
临界点后会发生什么？
04:30
Our microglia janitor cells
become hyper-activated,
become hyper-activated,
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我们的看护细胞小神经
胶质细胞变得过度活跃，
胶质细胞变得过度活跃，
04:33
releasing chemicals that cause
inflammation and cellular damage.
inflammation and cellular damage.
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释放出导致炎症和
细胞损伤的化学物质。
细胞损伤的化学物质。
04:37
We think they might actually
start clearing away
start clearing away
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我们认为这可能会
清除突触本身。
04:40
the synapses themselves.
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04:42
A crucial neural transport protein
called "tau" becomes hyperphosphorylated
called "tau" becomes hyperphosphorylated
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一种叫做tau蛋白的神经
转运蛋白变得过度磷酸化
转运蛋白变得过度磷酸化
04:46
and twists itself
into something called "tangles,"
into something called "tangles,"
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并转化成叫做神经纤维缠结的物质，
04:49
which choke off the neurons
from the inside.
from the inside.
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从内部阻塞了神经元。
04:52
By mid-stage Alzheimer's,
we have massive inflammation and tangles
we have massive inflammation and tangles
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在老年痴呆症的中期，
大量的炎症和神经纤维缠结
大量的炎症和神经纤维缠结
04:56
and all-out war at the synapse
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以及突触处的全面战争
04:58
and cell death.
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以及细胞的凋亡。
05:00
So if you were a scientist
trying to cure this disease,
trying to cure this disease,
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如果你是一位想要
治愈该病的科学家，
治愈该病的科学家，
05:03
at what point would you ideally
want to intervene?
want to intervene?
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最佳介入时机是什么时候呢？
05:07
Many scientists are betting big
on the simplest solution:
on the simplest solution:
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许多科学家赌在了
最简单的解决方法上：
最简单的解决方法上：
05:11
keep amyloid plaques
from reaching that tipping point,
from reaching that tipping point,
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避免淀粉样斑块达到临界点，
05:14
which means that drug discovery is largely
focused on developing a compound
focused on developing a compound
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也就意味着药物研发
很大程度上聚焦于
很大程度上聚焦于
研发一种可以预防、消除
或是减少淀粉样斑块积累的化合物。
或是减少淀粉样斑块积累的化合物。
05:18
that will prevent, eliminate, or reduce
amyloid plaque accumulation.
amyloid plaque accumulation.
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05:24
So the cure for Alzheimer's will likely be
a preventative medicine.
a preventative medicine.
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所以老年痴呆症的治疗方法
很有可能是一种预防性的药物。
很有可能是一种预防性的药物。
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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我们需要在临界点到达之前，
05:33
before the cascade is triggered,
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在连锁反应产生之前，
05:35
before we start leaving
our keys in the refrigerator.
our keys in the refrigerator.
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在我们把钥匙落在冰箱前
服用这种药物。
服用这种药物。
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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我们认为这也是迄今为止
这类药物在临床试验上
这类药物在临床试验上
05:43
in clinical trials --
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失败的原因。
05:44
not because the science wasn't sound,
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并不是因为科学技术不够可靠，
05:46
but because the people in these trials
were already symptomatic.
were already symptomatic.
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而是因为在临床试验的人们
都已是老年痴呆的患者。
都已是老年痴呆的患者。
05:50
It was too late.
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这就为时已晚。
05:52
Think of amyloid plaques as a lit match.
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试想淀粉样斑块是已经点燃的火柴。
05:55
At the tipping point, the match
sets fire to the forest.
sets fire to the forest.
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在临界点后，火柴的火引燃了整片森林。
05:59
Once the forest is ablaze,
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一旦森林起火，
06:01
it doesn't do any good
to blow out the match.
to blow out the match.
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吹灭火柴早已于事无补。
06:04
You have to blow out the match
before the forest catches fire.
before the forest catches fire.
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你需要在火柴引燃
森林前就把火柴熄灭。
森林前就把火柴熄灭。
06:08
Even before scientists sort this out,
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即使科学家还尚未解决问题，
06:10
this information is actually
really good news for us,
really good news for us,
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这一好消息确实振奋人心，
06:13
because it turns out that the way we live
can influence the accumulation
can influence the accumulation
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因为这证明了我们的生活方式
可以影响淀粉样斑块的积累。
06:17
of amyloid plaques.
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06:18
And so there are things we can do
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我们可以做许多小事
06:20
to keep us from reaching
that tipping point.
that tipping point.
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来避免达到临界点。
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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不妨把患老年痴呆的风险比作天平。
06:27
We're going to pile
risk factors on one arm,
risk factors on one arm,
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把可能增加风险的因素放在一端，
06:29
and when that arm hits the floor,
you are symptomatic
you are symptomatic
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如果一端触到地面，那么你将患病。
06:31
and diagnosed with Alzheimer's.
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并被诊断为老年痴呆。
06:34
Let's imagine you're 50 years old.
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假设你已五十岁。
06:36
You're not a spring chicken anymore,
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你已不再年轻，
06:38
so you've accumulated
some amyloid plaques with age.
some amyloid plaques with age.
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随年岁增长你已积累了部分淀粉样斑块。
06:41
Your scale is tipped a little bit.
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你的天平已经微微倾斜。
06:44
Now let's look at your DNA.
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现在观察一下你的DNA。
06:46
We've all inherited our genes
from our moms and our dads.
from our moms and our dads.
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我们的基因全部遗传自我们的父母。
06:50
Some of these genes will increase our risk
and some will decrease it.
and some will decrease it.
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一些基因会增加风险
还有一些会降低风险。
还有一些会降低风险。
06:54
If you're like Alice in "Still Alice,"
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如果你像《依然爱丽丝》中的爱丽丝一样，
06:56
you've inherited a rare genetic mutation
that cranks out amyloid beta,
that cranks out amyloid beta,
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你遗传的一种罕见的基因突变，
粗制滥造着β淀粉样蛋白，
粗制滥造着β淀粉样蛋白，
07:01
and this alone will tip
your scale arm to the ground.
your scale arm to the ground.
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单单这一点就会使你的天平一端着地。
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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不过对于大多数人而言
该基因只会使天平稍稍倾斜。
该基因只会使天平稍稍倾斜。
07:08
For example, APOE4 is a gene variant
that increases amyloid,
that increases amyloid,
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举个例子，APOE4是一种
增加淀粉样蛋白的变异基因，
增加淀粉样蛋白的变异基因，
07:13
but you can inherit a copy of APOE4
from mom and dad
from mom and dad
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你可能会从父母那里
遗传一份APOE4的基因
遗传一份APOE4的基因
07:16
and still never get Alzheimer's,
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不过却不会患上老年痴呆，
07:19
which means that for most of us,
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这也就意味着对大多数人而言，
07:21
our DNA alone does not determine
whether we get Alzheimer's.
whether we get Alzheimer's.
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我们的DNA并不是决定
老年痴呆的唯一要素。
老年痴呆的唯一要素。
07:25
So what does?
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那么什么决定呢？
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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我们对于衰老无能为力
也无法决定我们遗传的基因。
也无法决定我们遗传的基因。
07:31
So far, we haven't changed
our brain's destiny.
our brain's destiny.
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到现在我们还没有
改变我们大脑的宿命。
改变我们大脑的宿命。
07:35
What about sleep?
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关于睡眠呢？
07:37
In slow-wave deep sleep, our glial cells
rinse cerebral spinal fluid
rinse cerebral spinal fluid
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在慢波深度睡眠时，
我们的神经胶质细胞
我们的神经胶质细胞
冲洗着我们大脑中的脑脊液，
07:41
throughout our brains,
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07:42
clearing away metabolic waste
that accumulated in our synapses
that accumulated in our synapses
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清除掉积累在突触的代谢废物
07:46
while we were awake.
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当我们清醒时。
07:48
Deep sleep is like
a power cleanse for the brain.
a power cleanse for the brain.
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深度睡眠就好像是大脑的强效净化。
07:51
But what happens if you shortchange
yourself on sleep?
yourself on sleep?
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那么如果你在睡眠方面亏待了自己呢？
07:55
Many scientists believe
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许多科学家坚信
07:56
that poor sleep hygiene might actually
be a predictor of Alzheimer's.
be a predictor of Alzheimer's.
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不良的睡眠卫生可能
是老年痴呆的前兆。
是老年痴呆的前兆。
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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缺乏仅仅一晚的睡眠就会
增加β淀粉样蛋白。
增加β淀粉样蛋白。
08:07
And amyloid accumulation
has been shown to disrupt sleep,
has been shown to disrupt sleep,
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而淀粉样蛋白的累积
已被证实会影响睡眠，
已被证实会影响睡眠，
08:10
which in turn causes
more amyloid to accumulate.
more amyloid to accumulate.
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从而导致了更多淀粉样蛋白的累积。
08:13
And so now we have
this positive feedback loop
this positive feedback loop
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所以现在我们有了正反馈循环，
08:15
that's going to accelerate
the tipping of that scale.
the tipping of that scale.
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将会加剧天平的倾倒。
08:19
What else?
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还有别的吗？
08:20
Cardiovascular health.
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心血管的健康。
08:23
High blood pressure, diabetes,
obesity, smoking, high cholesterol,
obesity, smoking, high cholesterol,
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高血压、糖尿病、肥胖、
吸烟、高胆固醇，
吸烟、高胆固醇，
08:26
have all been shown to increase our risk
of developing Alzheimer's.
of developing Alzheimer's.
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这些都证明会增加患老年痴呆的风险。
08:30
Some autopsy studies have shown
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一些验尸报告表明
08:32
that as many as 80 percent
of people with Alzheimer's
of people with Alzheimer's
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有80%的老年痴呆患者
08:35
also had cardiovascular disease.
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同样患有心血管疾病。
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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许多研究表明有氧运动
在该病的动物模型试验中
在该病的动物模型试验中
可以有效减少β淀粉样蛋白。
08:43
in animal models of the disease.
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08:45
So a heart-healthy
Mediterranean lifestyle and diet
Mediterranean lifestyle and diet
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所以有益心脏健康的
地中海式生活方式和饮食
地中海式生活方式和饮食
08:49
can help to counter
the tipping of this scale.
the tipping of this scale.
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可以有效扳回倾斜的天平。
08:52
So there are many things we can do
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所以我们能做很多事
08:55
to prevent or delay
the onset of Alzheimer's.
the onset of Alzheimer's.
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来预防或者延缓老年痴呆症的到来。
08:57
But let's say
you haven't done any of them.
you haven't done any of them.
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不过假设你并没有做任何事。
09:00
Let's say you're 65;
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并且你已经六十五岁了，
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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你的家庭中有老年痴呆的患者
所以你可能遗传了一两种
可能会倾斜天平的基因，
可能会倾斜天平的基因，
09:06
that tips your scale arm a bit;
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09:08
you've been burning the candle
at both ends for years;
at both ends for years;
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你的生命之火渐渐微弱，
09:11
you love bacon;
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你喜欢培根，
09:12
and you don't run unless
someone's chasing you.
someone's chasing you.
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除非有人追你你懒得跑动。
09:14
(Laughter)
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（笑声）
09:16
Let's imagine that your amyloid plaques
have reached that tipping point.
have reached that tipping point.
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假设你的淀粉样斑块已经达到临界点。
09:19
Your scale arm has crashed to the floor.
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你天平的一端已坠地。
09:21
You've tripped the cascade,
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你触发了连锁反应，
09:23
setting fire to the forest,
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引发了森林火灾，
09:25
causing inflammation, tangles,
and cell death.
and cell death.
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导致了炎症、神经纤维
缠结以及细胞凋亡。
缠结以及细胞凋亡。
09:29
You should be symptomatic for Alzheimer's.
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你表现出老年痴呆的症状。
09:31
You should be having trouble
finding words and keys
finding words and keys
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你在措辞和找钥匙时会碰到麻烦
09:35
and remembering what I said
at the beginning of this talk.
at the beginning of this talk.
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并且回想不起我一开始讲的内容。
09:38
But you might not be.
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也许你不会这样。
09:41
There's one more thing you can do
to protect yourself
to protect yourself
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另外还有一件事可以帮助你
09:43
from experiencing
the symptoms of Alzheimer's,
the symptoms of Alzheimer's,
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免于老年痴呆的症状，
09:46
even if you have the full-blown disease
pathology ablaze in your brain.
pathology ablaze in your brain.
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哪怕你的大脑已病入膏肓。
09:50
It has to do with neural plasticity
and cognitive reserve.
and cognitive reserve.
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它需解决神经可塑性
和认知储备问题。
和认知储备问题。
09:55
Remember, the experience
of having Alzheimer's
of having Alzheimer's
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记住，老年痴呆症的发作
09:57
is ultimately a result of losing synapses.
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是突触损失的最终后果。
10:01
The average brain has
over a hundred trillion synapses,
over a hundred trillion synapses,
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一般大脑有超过万亿的突触，
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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这很不可思议，
我们有这么庞大的数量。
我们有这么庞大的数量。
10:07
And this isn't a static number.
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而这一数字不是一成不变。
10:09
We gain and lose synapses all the time,
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我们在一个叫做神经可塑性的过程之中，
10:11
through a process
called neural plasticity.
called neural plasticity.
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不断生成和消耗着突触。
10:14
Every time we learn something new,
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每当我们习得新东西，
10:16
we are creating and strengthening
new neural connections,
new neural connections,
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我们建立并强化新的神经连接，
10:20
new synapses.
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新的突触产生了。
10:22
In the Nun Study,
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在Nun研究中，
10:24
678 nuns, all over the age of 75
when the study began,
when the study began,
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研究开始时，678位修女全都年过七十五岁，
10:29
were followed for more than two decades.
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进行了二十多年的研究。
10:31
They were regularly given
physical checkups and cognitive tests,
physical checkups and cognitive tests,
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她们会定期接受身体检查和认知测试，
10:35
and when they died, their brains
were all donated for autopsy.
were all donated for autopsy.
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如果不行去世，她们的大脑
都捐献出去用于验尸。
都捐献出去用于验尸。
10:39
In some of these brains, scientists
discovered something surprising.
discovered something surprising.
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科学家们在一些大脑中
发现了一些神奇的东西。
发现了一些神奇的东西。
10:43
Despite the presence of plaques
and tangles and brain shrinkage --
and tangles and brain shrinkage --
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尽管样斑块、神经纤维
缠结和大脑的萎缩，
缠结和大脑的萎缩，
10:48
what appeared to be
unquestionable Alzheimer's --
unquestionable Alzheimer's --
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这些现象似乎是老年痴呆症无疑，
10:51
the nuns who had belonged
to these brains showed no signs
to these brains showed no signs
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然而这些大脑的主人
那些修女却没有在生前
表现出患有老年痴呆的症状。
表现出患有老年痴呆的症状。
10:54
of having the disease
while they were alive.
while they were alive.
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10:58
How can this be?
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这是怎么回事呢？
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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我们认为这是因为这些
修女拥有高级的认知储备，
修女拥有高级的认知储备，
11:04
which is a way of saying that they had
more functional synapses.
more functional synapses.
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意味着她们有功能更强的突触。
11:08
People who have more years
of formal education,
of formal education,
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接受正式教育的时间越长的人，
11:10
who have a high degree of literacy,
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拥有较强读写能力的人，
11:12
who engage regularly
in mentally stimulating activities,
in mentally stimulating activities,
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定期参加刺激心理活动的人，
11:16
all have more cognitive reserve.
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这些人都有更高的认知储备。
11:19
They have an abundance
and a redundancy in neural connections.
and a redundancy in neural connections.
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他们有着大量甚至多余的神经连接。
11:23
So even if they have a disease
like Alzheimer's
like Alzheimer's
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所以即使他们患上老年痴呆等疾病
11:25
compromising some of their synapses,
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损伤了部分突触，
11:28
they've got many extra backup connections,
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他们依然有充足的额外后备连接，
11:31
and this buffers them from noticing
that anything is amiss.
that anything is amiss.
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而这减缓了他们的大脑产生混乱。
11:34
Let's imagine a simplified example.
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让我们来看一个简单的例子。
11:37
Let's say you only know one thing
about a subject.
about a subject.
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假设你只知道关于某一主题的一件事。
11:40
Let's say it's about me.
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比方说是关于我的。
11:41
You know that Lisa Genova
wrote "Still Alice,"
wrote "Still Alice,"
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你知道丽莎·吉诺瓦
写下了《依然爱丽丝》，
写下了《依然爱丽丝》，
11:43
and that's the only thing
you know about me.
you know about me.
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这是你唯一知道的关于我的事。
11:46
You have that single neural connection,
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你拥有一处单一的神经连接，
11:48
that one synapse.
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那一个特定突触。
11:50
Now imagine you have Alzheimer's.
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如果现在你患上了老年痴呆。
11:52
You have plaques and tangles
and inflammation
and inflammation
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你有样斑块、神经纤维缠结和炎症
11:55
and microglia devouring that synapse.
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以及小神经胶质细胞吞噬了那一突触。
11:58
Now when someone asks you,
"Hey, who wrote 'Still Alice?'"
"Hey, who wrote 'Still Alice?'"
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现在若有人问起你
“嘿，谁写了《依然爱丽丝》？“
“嘿，谁写了《依然爱丽丝》？“
12:02
you can't remember,
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你无法回想起来了，
12:04
because that synapse
is either failing or gone.
is either failing or gone.
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因为那个突触要么衰弱要么消失了。
12:07
You've forgotten me forever.
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你把我忘得一干二净。
12:09
But what if you had learned more about me?
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但是如果你对我了解更深呢？
12:12
Let's say you learned
four things about me.
four things about me.
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比如你了解我的四件事情。
12:14
Now imagine you have Alzheimer's,
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现在如果你患上了老年痴呆，
12:16
and three of those synapses
are damaged or destroyed.
are damaged or destroyed.
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即使三处突触已损伤或者毁坏。
12:20
You still have a way
to detour the wreckage.
to detour the wreckage.
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你依然有一条路来
绕过阻碍找到我的信息。
绕过阻碍找到我的信息。
12:22
You can still remember my name.
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你依然记得我的名字。
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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所以我们可以通过使用那些未损坏的通路
12:29
through the recruitment
of yet-undamaged pathways.
of yet-undamaged pathways.
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有效应对老年痴呆。
12:32
And we create these pathways,
this cognitive reserve,
this cognitive reserve,
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同时我们通过学习新事物，
12:36
by learning new things.
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创造了新的通路，改变着认知储备。
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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理想情况下，我们希望
这些新事物的意义尽可能丰富，
这些新事物的意义尽可能丰富，
12:43
recruiting sight and sound
and associations and emotion.
and associations and emotion.
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吸纳视觉与听觉的联合感受。
12:48
So this really doesn't mean
doing crossword puzzles.
doing crossword puzzles.
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所以这并不意味着
去做横纵字谜游戏。
去做横纵字谜游戏。
12:51
You don't want to simply retrieve
information you've already learned,
information you've already learned,
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你不希望去重拾
那些你早已学会的信息，
那些你早已学会的信息，
12:55
because this is like traveling
down old, familiar streets,
down old, familiar streets,
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这就好比游览老旧的熟悉街道，
12:59
cruising neighborhoods you already know.
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那些周边环境你早已了然于心。
13:02
You want to pave new neural roads.
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你想要开辟新的神经道路。
13:04
Building an Alzheimer's-resistant brain
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使你的大脑抵抗老年痴呆
13:07
means learning to speak Italian,
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意味着学习说意大利语，
13:09
meeting new friends,
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去遇见新朋友，
13:11
reading a book,
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读一本书，
13:12
or listening to a great TED Talk.
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或是听一场精彩的TED演讲。
13:15
And if, despite all of this, you are
someday diagnosed with Alzheimer's,
someday diagnosed with Alzheimer's,
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如果做了所有的这一切之后
有一天你被诊断为老年痴呆，
有一天你被诊断为老年痴呆，
13:20
there are three lessons I've learned
from my grandmother
from my grandmother
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我从我的祖母以及我认识的许多患者中
13:23
and the dozens of people I've come to know
living with this disease.
living with this disease.
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学习到了三件事情。
13:28
Diagnosis doesn't mean
you're dying tomorrow.
you're dying tomorrow.
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诊断并不意味着死期将至。
13:31
Keep living.
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顽强地活下去吧。
13:33
You won't lose your emotional memory.
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你不会丢失你的情感记忆。
13:35
You'll still be able
to understand love and joy.
to understand love and joy.
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你依然可以理解爱与喜悦。
13:38
You might not remember
what I said five minutes ago,
what I said five minutes ago,
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你也许不会记得我五分钟前的话语，
13:42
but you'll remember how I made you feel.
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但是你依然会记得我带给你的感受。
13:44
And you are more than what
you can remember.
you can remember.
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你远胜于你所能记住的一切。
13:48
Thank you.
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谢谢。
13:49
(Applause)
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（掌声）
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