TED2017
Lisa Genova: What you can do to prevent Alzheimer's
Lisa Genova: Que se pode facer para previr o alzhéimer
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O alzhéimer non ten por que ser o destino do seu cerebro, afirma Lisa Genova, neurocientífica e autora do libro "Still Alice". Lisa comparte as últimas investigacións científicas sobre a doenza, así coma estudos prometedores sobre o que cadaquén pode facer para crear resistencia cerebral ante o alzhéimer.
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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A canta xente de aquí lle gustaría vivir
ata ter polo menos 80 anos?
ata ter polo menos 80 anos?
00:18
Yeah.
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Si.
00:19
I think we all have
this hopeful expectation
this hopeful expectation
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Penso que todos temos esta esperanza
00:22
of living into old age.
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de vivir ata a vellez.
00:24
Let's project out into the future,
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Imos proxectarnos no futuro,
00:26
to your future "you's,"
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nos "vostedes" futuros,
00:28
and let's imagine that we're all 85.
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e imos imaxinar que todos temos 85 anos.
00:31
Now, everyone look at two people.
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Agora mírense uns aos outros.
00:35
One of you probably has
Alzheimer's disease.
Alzheimer's disease.
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Un de vostedes
probablemente terá alzhéimer.
probablemente terá alzhéimer.
00:39
(Laughter)
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(Risos)
00:42
Alright, alright.
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Vale, vale.
00:44
And maybe you're thinking,
"Well, it won't be me."
"Well, it won't be me."
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E se cadra están a pensar:
"Ben, non serei eu".
"Ben, non serei eu".
00:49
Then, OK. You are a caregiver.
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Entón é vostede un coidador.
00:53
So --
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Así que...
00:54
(Laughter)
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(Risos)
00:57
so in some way,
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dalgún xeito,
00:58
this terrifying disease
is likely to affect us all.
is likely to affect us all.
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esta terrible doenza
é probable que nos afecte a todos.
é probable que nos afecte a todos.
01:02
Part of the fear around Alzheimer's
stems from the sense
stems from the sense
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Parte do medo que rodea o alzhéimer
provén da idea
provén da idea
01:05
that there's nothing we can do about it.
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de que non hai nada que poidamos facer.
01:08
Despite decades of research, we still
have no disease-modifying treatment
have no disease-modifying treatment
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Malia décadas de investigación, aínda
non temos tratamento contra esta doenza
non temos tratamento contra esta doenza
01:13
and no cure.
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nin curación.
01:15
So if we're lucky enough
to live long enough,
to live long enough,
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Se temos sorte dabondo
para vivirmos moitos anos,
para vivirmos moitos anos,
01:17
Alzheimer's appears to be
our brain's destiny.
our brain's destiny.
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parece que o alzhéimer
será o destino do noso cerebro.
será o destino do noso cerebro.
01:21
But maybe it doesn't have to be.
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Mais se cadra non ten por que ser.
01:23
What if I told you we could
change these statistics,
change these statistics,
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E se lles digo que podemos
mudar as estatísticas,
mudar as estatísticas,
01:26
literally change our brain's destiny,
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literalmente mudar o destino
do noso cerebro,
do noso cerebro,
01:29
without relying on a cure
or advancements in medicine?
or advancements in medicine?
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sen depender dunha curación
ou dos avances da medicina?
ou dos avances da medicina?
01:33
Let's begin by looking at
what we currently understand
what we currently understand
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Comecemos por revisar
o que se sabe actualmente
o que se sabe actualmente
01:36
about the neuroscience of Alzheimer's.
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sobre a neurociencia do alzhéimer.
01:39
Here's a picture
of two neurons connecting.
of two neurons connecting.
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Aquí teñen un debuxo
de dúas neuronas conectadas.
de dúas neuronas conectadas.
01:42
The point of connection,
this space circled in red,
this space circled in red,
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O punto de conexión,
este espazo cun círculo vermello,
este espazo cun círculo vermello,
01:46
is called the synapse.
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chámase sinapse.
01:47
The synapse is where
neurotransmitters are released.
neurotransmitters are released.
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A sinapse é onde se liberan
os neurotransmisores.
os neurotransmisores.
01:51
This is where signals are transmitted,
where communication happens.
where communication happens.
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Aquí é onde se transmiten os sinais,
onde se produce a comunicación.
onde se produce a comunicación.
01:55
This is where we think,
feel, see, hear, desire ...
feel, see, hear, desire ...
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Aquí é onde pensamos,
sentimos, vemos, oímos, desexamos...
sentimos, vemos, oímos, desexamos...
02:00
and remember.
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e lembramos.
02:02
And the synapse
is where Alzheimer's happens.
is where Alzheimer's happens.
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E na sinapse
é onde se produce o alzhéimer.
é onde se produce o alzhéimer.
02:05
Let's zoom in on the synapse
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Imos ampliar a sinapse
02:07
and look at a cartoon representation
of what's going on.
of what's going on.
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e mirar unha representación con debuxos
do que acontece.
do que acontece.
02:10
During the business
of communicating information,
of communicating information,
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Durante o proceso
de comunicación da información,
de comunicación da información,
02:13
in addition to releasing neurotransmitters
like glutamate into the synapse,
like glutamate into the synapse,
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ademais de liberar neurotransmisores
coma o glutamato na sinapse,
coma o glutamato na sinapse,
02:17
neurons also release a small peptide
called amyloid beta.
called amyloid beta.
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as neuronas tamén liberan
un pequeno péptido chamado amiloide beta.
un pequeno péptido chamado amiloide beta.
Normalmente o amiloide beta elimínase
metabolizado polas microglías,
metabolizado polas microglías,
02:22
Normally, amyloid beta is cleared away
metabolized by microglia,
metabolized by microglia,
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02:27
the janitor cells of our brains.
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as células conserxe do noso cerebro.
02:30
While the molecular causes
of Alzheimer's are still debated,
of Alzheimer's are still debated,
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Mentres que aínda están en debate
as causas moleculares do alzhéimer,
as causas moleculares do alzhéimer,
02:34
most neuroscientists believe
that the disease begins
that the disease begins
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a maioría dos neurocientíficos cre
que a doenza comeza
que a doenza comeza
02:37
when amyloid beta begins to accumulate.
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cando os amiloides beta empezan
a se acumularen.
a se acumularen.
02:40
Too much is released,
or not enough is cleared away,
or not enough is cleared away,
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Libéranse demasiados
ou non se eliminan os suficientes,
ou non se eliminan os suficientes,
02:43
and the synapse begins
to pile up with amyloid beta.
to pile up with amyloid beta.
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e a sinapse comeza
a acumular amiloides beta.
a acumular amiloides beta.
02:47
And when this happens, it binds to itself,
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Cando acontece isto, únense a si mesmos,
02:49
forming sticky aggregates
called amyloid plaques.
called amyloid plaques.
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formando adherencias
chamadas placas amiloides.
chamadas placas amiloides.
02:53
How many people here
are 40 years old or older?
are 40 years old or older?
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Canta xente de aquí ten 40 anos ou máis?
02:57
You're afraid to admit it now.
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Teñen medo de recoñecelo agora.
02:59
This initial step into the disease,
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Este paso inicial da doenza,
03:01
this presence of amyloid
plaques accumulating,
plaques accumulating,
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esta presenza de placas amiloides
que se acumulan,
que se acumulan,
03:05
can already be found in your brains.
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xa se pode atopar nos seus cerebros.
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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O único xeito de estarmos seguros disto
sería facer un escáner TEP,
sería facer un escáner TEP,
03:11
because at this point,
you are blissfully unaware.
you are blissfully unaware.
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porque neste momento
vivimos nunha feliz ignorancia.
vivimos nunha feliz ignorancia.
03:15
You're not showing any impairments
in memory, language, or cognition ...
in memory, language, or cognition ...
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Non amosamos ningunha deterioración
da memoria, linguaxe ou coñecemento...
da memoria, linguaxe ou coñecemento...
03:19
yet.
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aínda.
03:21
We think it takes at least 15 to 20 years
of amyloid plaque accumulation
of amyloid plaque accumulation
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Pensamos que se tarda entre 15 e 20 anos
en acumular placa amiloide
en acumular placa amiloide
03:26
before it reaches a tipping point,
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antes de que alcance o punto crítico,
03:28
then triggering a molecular cascade
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logo desencadea un cadoiro molecular
03:30
that causes the clinical
symptoms of the disease.
symptoms of the disease.
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que provoca os síntomas da doenza.
03:33
Prior to the tipping point,
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Antes do punto crítico,
03:35
your lapses in memory
might include things like,
might include things like,
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os lapsos da memoria
poden incluír cousas coma:
poden incluír cousas coma:
03:39
"Why did I come in this room?"
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"Por que entrei neste cuarto?"
03:41
or "Oh ... what's his name?"
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ou "Oh... Como se chama?"
03:44
or "Where did I put my keys?"
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ou "Onde botei as chaves?"
03:47
Now, before you all
start freaking out again,
start freaking out again,
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Agora, antes de que todos
se asusten de novo
se asusten de novo
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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(porque sei que polo menos a metade
tivo algún destes nas últimas 24 horas)
tivo algún destes nas últimas 24 horas)
03:55
these are all normal kinds of forgetting.
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trátase de esquecementos normais.
03:58
In fact, I would argue that these examples
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De feito, eu sostería que estes exemplos
04:01
might not even involve your memory,
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poderían non involucrar a súa memoria,
04:03
because you didn't pay attention
to where you put your keys
to where you put your keys
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porque non prestou atención
a onde botou as chaves
a onde botou as chaves
en primeiro lugar.
04:06
in the first place.
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04:07
After the tipping point,
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Tras o punto crítico,
04:09
the glitches in memory,
language and cognition are different.
language and cognition are different.
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os problemas de memoria,
linguaxe e coñecemento son diferentes.
linguaxe e coñecemento son diferentes.
04:12
Instead of eventually finding
your keys in your coat pocket
your keys in your coat pocket
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No canto de atopar as chaves
no peto do abrigo
no peto do abrigo
04:15
or on the table by the door,
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ou na mesa que está onda a porta,
04:17
you find them in the refrigerator,
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atópaas no frigorífico,
04:20
or you find them and you think,
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ou atópaas e pensa:
04:22
"What are these for?"
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"Isto para que é?"
04:24
So what happens when amyloid plaques
accumulate to this tipping point?
accumulate to this tipping point?
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Que acontece cando as placas amiloides
se acumulan ata este punto crítico?
se acumulan ata este punto crítico?
04:30
Our microglia janitor cells
become hyper-activated,
become hyper-activated,
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As nosas células conserxe microglías
tórnanse hiperactivas
tórnanse hiperactivas
04:33
releasing chemicals that cause
inflammation and cellular damage.
inflammation and cellular damage.
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e liberan substancias químicas que causan
dano celular e inflamación.
dano celular e inflamación.
04:37
We think they might actually
start clearing away
start clearing away
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Pensamos que poderían en realidade
comezar a eliminar
comezar a eliminar
04:40
the synapses themselves.
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a sinapses elas mesmas.
04:42
A crucial neural transport protein
called "tau" becomes hyperphosphorylated
called "tau" becomes hyperphosphorylated
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Unha proteína neurotransportadora crucial
denominada "tau" vólvese hiperfosforilada
denominada "tau" vólvese hiperfosforilada
04:46
and twists itself
into something called "tangles,"
into something called "tangles,"
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e retórcese
en vultos denominados "nobelos",
en vultos denominados "nobelos",
04:49
which choke off the neurons
from the inside.
from the inside.
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que cortan as neuronas
desde o interior.
desde o interior.
04:52
By mid-stage Alzheimer's,
we have massive inflammation and tangles
we have massive inflammation and tangles
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Na fase intermedia do alzhéimer,
temos inflamación masiva e nobelos,
temos inflamación masiva e nobelos,
04:56
and all-out war at the synapse
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unha guerra sen cuartel na sinapse
04:58
and cell death.
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e morte celular.
05:00
So if you were a scientist
trying to cure this disease,
trying to cure this disease,
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Se vostede fose un científico
que tenta curar esta doenza,
que tenta curar esta doenza,
05:03
at what point would you ideally
want to intervene?
want to intervene?
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cal sería o punto ideal
no que desexaría intervir?
no que desexaría intervir?
05:07
Many scientists are betting big
on the simplest solution:
on the simplest solution:
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Moitos científicos están apostando alto
pola solución máis simple:
pola solución máis simple:
05:11
keep amyloid plaques
from reaching that tipping point,
from reaching that tipping point,
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manter as placas amiloides
lonxe de alcanzar o punto crítico,
lonxe de alcanzar o punto crítico,
05:14
which means that drug discovery is largely
focused on developing a compound
focused on developing a compound
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polo que a investigación farmacéutica
céntrase en desenvolver un composto
céntrase en desenvolver un composto
05:18
that will prevent, eliminate, or reduce
amyloid plaque accumulation.
amyloid plaque accumulation.
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que evite, elimine ou reduza
a acumulación de placa amiloide.
a acumulación de placa amiloide.
05:24
So the cure for Alzheimer's will likely be
a preventative medicine.
a preventative medicine.
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Así que a cura do alzhéimer probablemente
será a medicina preventiva.
será a medicina preventiva.
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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Imos ter que tomar esta pastilla
antes de alcanzar o punto crítico,
antes de alcanzar o punto crítico,
05:33
before the cascade is triggered,
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antes de que se desencadee o cadoiro,
05:35
before we start leaving
our keys in the refrigerator.
our keys in the refrigerator.
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antes de que empecemos a deixar
as chaves no frigorífico.
as chaves no frigorífico.
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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Pensamos que esta é a razón de que,
ata agora, fallasen este tipo de fármacos
ata agora, fallasen este tipo de fármacos
05:43
in clinical trials --
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en ensaios clínicos...
05:44
not because the science wasn't sound,
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non por non contar cunha ciencia sólida
05:46
but because the people in these trials
were already symptomatic.
were already symptomatic.
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senón porque as persoas destes ensaios
xa manifestaban síntomas.
xa manifestaban síntomas.
05:50
It was too late.
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Era demasiado tarde.
05:52
Think of amyloid plaques as a lit match.
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Imaxinen que as placas amiloides
son mistos acendidos.
son mistos acendidos.
05:55
At the tipping point, the match
sets fire to the forest.
sets fire to the forest.
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No punto crítico,
o misto incendia o monte.
o misto incendia o monte.
05:59
Once the forest is ablaze,
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Cando o monte está a arder,
06:01
it doesn't do any good
to blow out the match.
to blow out the match.
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non serve de nada
soprarlle ao misto.
soprarlle ao misto.
06:04
You have to blow out the match
before the forest catches fire.
before the forest catches fire.
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Hai que soprarlle ao misto
antes de que o monte se incendie.
antes de que o monte se incendie.
Incluso antes de que os científicos
o solucionen,
o solucionen,
06:08
Even before scientists sort this out,
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06:10
this information is actually
really good news for us,
really good news for us,
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esta información en realidade
son boas novas para nós,
son boas novas para nós,
06:13
because it turns out that the way we live
can influence the accumulation
can influence the accumulation
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porque resulta que o noso xeito de vivir
pode ter influencia sobre a acumulación
pode ter influencia sobre a acumulación
06:17
of amyloid plaques.
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de placas amiloides.
06:18
And so there are things we can do
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Así que podemos facer algo
06:20
to keep us from reaching
that tipping point.
that tipping point.
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para estarmos lonxe de alcanzar
o punto crítico.
o punto crítico.
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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Poñamos o risco de que sufran alzhéimer
coma nunha balanza.
coma nunha balanza.
06:27
We're going to pile
risk factors on one arm,
risk factors on one arm,
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Imos acumular factores de risco nun brazo
06:29
and when that arm hits the floor,
you are symptomatic
you are symptomatic
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e, cando ese brazo choque no chan,
vostede ten síntomas
vostede ten síntomas
06:31
and diagnosed with Alzheimer's.
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e diagnostícanlle alzhéimer.
06:34
Let's imagine you're 50 years old.
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Imaxine que ten 50 anos.
06:36
You're not a spring chicken anymore,
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xa non é un rapaz,
06:38
so you've accumulated
some amyloid plaques with age.
some amyloid plaques with age.
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así que leva acumuladas
placas amiloides coa idade.
placas amiloides coa idade.
06:41
Your scale is tipped a little bit.
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A súa balanza inclínase un pouquiño.
06:44
Now let's look at your DNA.
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Agora observemos o seu ADN.
06:46
We've all inherited our genes
from our moms and our dads.
from our moms and our dads.
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Herdamos os nosos xenes
das nosas nais e dos nosos pais.
das nosas nais e dos nosos pais.
06:50
Some of these genes will increase our risk
and some will decrease it.
and some will decrease it.
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Algúns destes xenes aumentarán o risco
e outros diminuirano.
e outros diminuirano.
06:54
If you're like Alice in "Still Alice,"
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Se vostede é como Alice en Still Alice,
06:56
you've inherited a rare genetic mutation
that cranks out amyloid beta,
that cranks out amyloid beta,
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herdou unha mutación xenética rara
que produce amiloides beta,
que produce amiloides beta,
07:01
and this alone will tip
your scale arm to the ground.
your scale arm to the ground.
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e isto só inclinará
a súa balanza ata o chan.
a súa balanza ata o chan.
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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Pero na maioría de nós, os xenes herdados
só inclinarán un pouco o brazo.
só inclinarán un pouco o brazo.
07:08
For example, APOE4 is a gene variant
that increases amyloid,
that increases amyloid,
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Por exemplo, o APOE4 é unha variante
xenética que aumenta o amiloide,
xenética que aumenta o amiloide,
07:13
but you can inherit a copy of APOE4
from mom and dad
from mom and dad
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pero pódese herdar unha copia da APOE4
da nai e do pai
da nai e do pai
07:16
and still never get Alzheimer's,
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e nunca ter alzhéimer,
07:19
which means that for most of us,
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o que significa que na maioría de nós
07:21
our DNA alone does not determine
whether we get Alzheimer's.
whether we get Alzheimer's.
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o noso ADN só non determina
se imos padecer alzhéimer.
se imos padecer alzhéimer.
07:25
So what does?
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Entón que o determina?
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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Non podemos evitar envellecer
nin os xenes que herdamos.
nin os xenes que herdamos.
07:31
So far, we haven't changed
our brain's destiny.
our brain's destiny.
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Ata agora, non cambiamos
o destino do noso cerebro.
o destino do noso cerebro.
07:35
What about sleep?
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Que pasa co sono?
07:37
In slow-wave deep sleep, our glial cells
rinse cerebral spinal fluid
rinse cerebral spinal fluid
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No sono profundo, as nosas células gliais
limpan o fluído espinal cerebral
limpan o fluído espinal cerebral
07:41
throughout our brains,
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por todo o cerebro,
07:42
clearing away metabolic waste
that accumulated in our synapses
that accumulated in our synapses
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eliminando os refugallos metabólicos
que se acumulan nas nosas sinapses
que se acumulan nas nosas sinapses
07:46
while we were awake.
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mentres estamos espertos.
07:48
Deep sleep is like
a power cleanse for the brain.
a power cleanse for the brain.
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O sono profundo é coma
un potente limpador para o cerebro.
un potente limpador para o cerebro.
07:51
But what happens if you shortchange
yourself on sleep?
yourself on sleep?
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Pero que ocorre se non se aproveita
ben o sono?
ben o sono?
07:55
Many scientists believe
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Moitos científicos cren
07:56
that poor sleep hygiene might actually
be a predictor of Alzheimer's.
be a predictor of Alzheimer's.
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que unha mala hixiene de sono pode
realmente predicir o alzhéimer.
realmente predicir o alzhéimer.
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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Unha soa noite de privación do sono
provoca un incremento de amiloides beta.
provoca un incremento de amiloides beta.
08:07
And amyloid accumulation
has been shown to disrupt sleep,
has been shown to disrupt sleep,
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E demostrouse que
a acumulación de amiloides altera o sono,
a acumulación de amiloides altera o sono,
08:10
which in turn causes
more amyloid to accumulate.
more amyloid to accumulate.
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que á súa vez provoca
máis acumulación de amiloides.
máis acumulación de amiloides.
08:13
And so now we have
this positive feedback loop
this positive feedback loop
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Entón agora temos
esta retroalimentación positiva
esta retroalimentación positiva
08:15
that's going to accelerate
the tipping of that scale.
the tipping of that scale.
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que vai acelerar a inclinación da balanza.
08:19
What else?
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Que máis?
08:20
Cardiovascular health.
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Saúde cardiovascular.
08:23
High blood pressure, diabetes,
obesity, smoking, high cholesterol,
obesity, smoking, high cholesterol,
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Tensión arterial alta, diabetes,
obesidade, tabaquismo e colesterol alto...
obesidade, tabaquismo e colesterol alto...
08:26
have all been shown to increase our risk
of developing Alzheimer's.
of developing Alzheimer's.
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está demostrado que incrementan
o noso risco de padecer alzhéimer.
o noso risco de padecer alzhéimer.
08:30
Some autopsy studies have shown
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Algunhas autopsias demostraron
08:32
that as many as 80 percent
of people with Alzheimer's
of people with Alzheimer's
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que un 80 por cento
de persoas con alzhéimer
de persoas con alzhéimer
08:35
also had cardiovascular disease.
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tamén ten trastornos cardiovasculares.
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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Moitos estudos demostraron que o exercicio
aeróbico diminúe os amiloides beta
aeróbico diminúe os amiloides beta
08:43
in animal models of the disease.
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en modelos animais da doenza.
08:45
So a heart-healthy
Mediterranean lifestyle and diet
Mediterranean lifestyle and diet
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Así que o estilo de vida e a dieta
mediterránea, saudable para o corazón,
mediterránea, saudable para o corazón,
poden axudar a contrarrestar
a inclinación da balanza.
a inclinación da balanza.
08:49
can help to counter
the tipping of this scale.
the tipping of this scale.
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08:52
So there are many things we can do
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Así que hai moitas cousas
que podemos facer
que podemos facer
08:55
to prevent or delay
the onset of Alzheimer's.
the onset of Alzheimer's.
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para previr ou atrasar
a aparición do alzhéimer.
a aparición do alzhéimer.
08:57
But let's say
you haven't done any of them.
you haven't done any of them.
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Pero poñamos que
non fixeron nada diso.
non fixeron nada diso.
09:00
Let's say you're 65;
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Digamos que teñen 65 anos;
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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hai alzhéimer na súa familia, así que
é probable que herdasen un xene ou dous
é probable que herdasen un xene ou dous
09:06
that tips your scale arm a bit;
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que inclina o brazo da balanza un pouco;
09:08
you've been burning the candle
at both ends for years;
at both ends for years;
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estiveron anos queimando a candea
polos dous extremos;
polos dous extremos;
09:11
you love bacon;
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encántalles o touciño;
09:12
and you don't run unless
someone's chasing you.
someone's chasing you.
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e non corren a non ser que
alguén os persiga.
alguén os persiga.
09:14
(Laughter)
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(Risos)
09:16
Let's imagine that your amyloid plaques
have reached that tipping point.
have reached that tipping point.
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Imaxinemos que as súas placas amiloides
alcanzaron o punto crítico.
alcanzaron o punto crítico.
09:19
Your scale arm has crashed to the floor.
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O brazo da balanza chegou ata o chan.
09:21
You've tripped the cascade,
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Desencadeouse o cadoiro,
09:23
setting fire to the forest,
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prendeu lume no monte,
09:25
causing inflammation, tangles,
and cell death.
and cell death.
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provocando inflamación, nobelos
e morte celular.
e morte celular.
09:29
You should be symptomatic for Alzheimer's.
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Deben ter síntomas de alzhéimer.
09:31
You should be having trouble
finding words and keys
finding words and keys
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Deben ter problemas
para atopar palabras e as chaves
para atopar palabras e as chaves
09:35
and remembering what I said
at the beginning of this talk.
at the beginning of this talk.
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e lembrar o que dixen
ao comezo desta charla.
ao comezo desta charla.
09:38
But you might not be.
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Pero poida que non.
09:41
There's one more thing you can do
to protect yourself
to protect yourself
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Hai unha cousa máis que poden facer
para se protexer
para se protexer
09:43
from experiencing
the symptoms of Alzheimer's,
the symptoms of Alzheimer's,
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de experimentar
os síntomas do alzhéimer,
os síntomas do alzhéimer,
09:46
even if you have the full-blown disease
pathology ablaze in your brain.
pathology ablaze in your brain.
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mesmo se teñen toda a patoloxía
da doenza desencadeada no seu cerebro.
da doenza desencadeada no seu cerebro.
09:50
It has to do with neural plasticity
and cognitive reserve.
and cognitive reserve.
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Ten que ver coa neuroplasticidade
e a reserva cognitiva.
e a reserva cognitiva.
09:55
Remember, the experience
of having Alzheimer's
of having Alzheimer's
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Lembren que a experiencia
de padecer alzhéimer
de padecer alzhéimer
09:57
is ultimately a result of losing synapses.
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é o resultado final da perda de sinapses.
10:01
The average brain has
over a hundred trillion synapses,
over a hundred trillion synapses,
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Un cerebro medio ten
máis de cen billóns de sinapses,
máis de cen billóns de sinapses,
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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o que é fantástico;
temos moito co que traballar.
temos moito co que traballar.
10:07
And this isn't a static number.
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E non se trata dun número estático.
10:09
We gain and lose synapses all the time,
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Gañamos e perdemos sinapses continuamente,
10:11
through a process
called neural plasticity.
called neural plasticity.
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a través dun proceso
denominado neuroplasticidade.
denominado neuroplasticidade.
10:14
Every time we learn something new,
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Cada vez que aprendemos algo novo,
10:16
we are creating and strengthening
new neural connections,
new neural connections,
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estamos a crear e fortalecer
novas conexións neurais,
novas conexións neurais,
10:20
new synapses.
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novas sinapses.
10:22
In the Nun Study,
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Nun estudo con monxas,
10:24
678 nuns, all over the age of 75
when the study began,
when the study began,
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678 monxas, todas de máis de 75 anos
cando comezou o estudo,
cando comezou o estudo,
10:29
were followed for more than two decades.
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2309
sometéronse a un seguimento
durante máis de dúas décadas.
durante máis de dúas décadas.
10:31
They were regularly given
physical checkups and cognitive tests,
physical checkups and cognitive tests,
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Facíanlles regularmente
revisións físicas e tests cognitivos,
revisións físicas e tests cognitivos,
10:35
and when they died, their brains
were all donated for autopsy.
were all donated for autopsy.
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e cando faleceron, doaron os cerebros
para realizar unha autopsia.
para realizar unha autopsia.
10:39
In some of these brains, scientists
discovered something surprising.
discovered something surprising.
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Nalgúns destes cerebros, os científicos
descubriron algo sorprendente.
descubriron algo sorprendente.
10:43
Despite the presence of plaques
and tangles and brain shrinkage --
and tangles and brain shrinkage --
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Malia a presenza de placas,
nobelos e perda cerebral,
nobelos e perda cerebral,
10:48
what appeared to be
unquestionable Alzheimer's --
unquestionable Alzheimer's --
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o que semellaba ser alzhéimer
de xeito incuestionable,
de xeito incuestionable,
10:51
the nuns who had belonged
to these brains showed no signs
to these brains showed no signs
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as monxas ás que pertencían eses cerebros
non manifestaban signos
non manifestaban signos
10:54
of having the disease
while they were alive.
while they were alive.
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de padecer a doenza
mentres estaban vivas.
mentres estaban vivas.
10:58
How can this be?
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Como é posible?
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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Pensamos que se debe a que estas monxas
tiñan un alto nivel de reserva cognitiva,
tiñan un alto nivel de reserva cognitiva,
11:04
which is a way of saying that they had
more functional synapses.
more functional synapses.
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que é un xeito de dicir que tiñan
máis sinapses funcionais.
máis sinapses funcionais.
11:08
People who have more years
of formal education,
of formal education,
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As persoas que teñen máis anos
de formación académica,
de formación académica,
11:10
who have a high degree of literacy,
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que teñen un alto grao de alfabetización,
11:12
who engage regularly
in mentally stimulating activities,
in mentally stimulating activities,
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que se implican habitualmente
en actividades que estimulan a mente,
en actividades que estimulan a mente,
11:16
all have more cognitive reserve.
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dispoñen de máis reserva cognitiva.
11:19
They have an abundance
and a redundancy in neural connections.
and a redundancy in neural connections.
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Teñen unha abundancia
e redundancia de conexións neurais.
e redundancia de conexións neurais.
11:23
So even if they have a disease
like Alzheimer's
like Alzheimer's
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Así que aínda que teñan unha doenza
coma o alzhéimer,
coma o alzhéimer,
11:25
compromising some of their synapses,
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que afecta algunhas das súas sinapses,
11:28
they've got many extra backup connections,
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teñen moitas conexións extra de reserva,
11:31
and this buffers them from noticing
that anything is amiss.
that anything is amiss.
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e isto protéxeas de notar
que existe unha perda.
que existe unha perda.
11:34
Let's imagine a simplified example.
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Imaxinemos un exemplo simplificado.
11:37
Let's say you only know one thing
about a subject.
about a subject.
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Poñamos que só saben unha cousa
sobre un tema.
sobre un tema.
11:40
Let's say it's about me.
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Digamos que é sobre min.
11:41
You know that Lisa Genova
wrote "Still Alice,"
wrote "Still Alice,"
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2306
Saben que Lisa Genova
escribiu Still Alice,
escribiu Still Alice,
11:43
and that's the only thing
you know about me.
you know about me.
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e iso é o único que saben sobre min.
11:46
You have that single neural connection,
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Teñen esa única conexión neural,
11:48
that one synapse.
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1946
esa única sinapse.
11:50
Now imagine you have Alzheimer's.
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2161
Agora imaxinen que padecen Alzheimer.
11:52
You have plaques and tangles
and inflammation
and inflammation
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Teñen placas, nobelos, inflamación
11:55
and microglia devouring that synapse.
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2735
e as microglías que devoran esa sinapse.
11:58
Now when someone asks you,
"Hey, who wrote 'Still Alice?'"
"Hey, who wrote 'Still Alice?'"
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Agora cando alguén lles pregunta
se saben quen escribiu Still Alice
se saben quen escribiu Still Alice
12:02
you can't remember,
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non se lembran,
12:04
because that synapse
is either failing or gone.
is either failing or gone.
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3183
porque esa sinapse está a fallar
ou desapareceu.
ou desapareceu.
12:07
You've forgotten me forever.
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Esquecéronme para sempre.
12:09
But what if you had learned more about me?
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2626
Pero que acontece
se teñen máis información sobre min?
se teñen máis información sobre min?
12:12
Let's say you learned
four things about me.
four things about me.
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Digamos que aprenderon
catro cousas de min.
catro cousas de min.
12:14
Now imagine you have Alzheimer's,
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Imaxinemos que padecen alzhéimer,
12:16
and three of those synapses
are damaged or destroyed.
are damaged or destroyed.
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e tres desas sinapses
están deterioradas ou destruídas.
están deterioradas ou destruídas.
12:20
You still have a way
to detour the wreckage.
to detour the wreckage.
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Aínda teñen un xeito
de desviar o desastre.
de desviar o desastre.
12:22
You can still remember my name.
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2019
Aínda poden lembrar o meu nome.
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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Así que podemos ser resilientes
á presenza da enfermidade de alzhéimer
á presenza da enfermidade de alzhéimer
12:29
through the recruitment
of yet-undamaged pathways.
of yet-undamaged pathways.
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a través da captación
de vías aínda non deterioradas.
de vías aínda non deterioradas.
12:32
And we create these pathways,
this cognitive reserve,
this cognitive reserve,
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E creamos estas vías,
esta reserva cognitiva,
esta reserva cognitiva,
12:36
by learning new things.
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1700
aprendendo cousas novas.
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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4521
O ideal é que estas cousas novas sexan
tan ricas en significado como for posible,
tan ricas en significado como for posible,
12:43
recruiting sight and sound
and associations and emotion.
and associations and emotion.
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captando vista e oído,
así como asociacións e emoción.
así como asociacións e emoción.
12:48
So this really doesn't mean
doing crossword puzzles.
doing crossword puzzles.
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Así que isto en realidade non significa
facer encrucillados.
facer encrucillados.
12:51
You don't want to simply retrieve
information you've already learned,
information you've already learned,
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4097
Non se trata de simplemente recuperar
información que xa aprenderon,
información que xa aprenderon,
12:55
because this is like traveling
down old, familiar streets,
down old, familiar streets,
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3343
porque iso é como viaxar
ao pasado, a rúas familiares,
ao pasado, a rúas familiares,
12:59
cruising neighborhoods you already know.
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atopándose con veciños que xa coñecen.
13:02
You want to pave new neural roads.
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Trátase de asfaltar novas vías neurais.
13:04
Building an Alzheimer's-resistant brain
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2512
Crear un cerebro resistente ao alzhéimer
13:07
means learning to speak Italian,
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2180
significa aprender a falar italiano,
13:09
meeting new friends,
256
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1510
coñecer novos amigos,
13:11
reading a book,
257
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1167
ler un libro
13:12
or listening to a great TED Talk.
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2369
ou escoitar unha gran charla TED.
13:15
And if, despite all of this, you are
someday diagnosed with Alzheimer's,
someday diagnosed with Alzheimer's,
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5313
E se, malia todo isto, algún día
lle diagnostican alzhéimer,
lle diagnostican alzhéimer,
13:20
there are three lessons I've learned
from my grandmother
from my grandmother
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hai tres leccións que aprendín
da miña avoa
da miña avoa
13:23
and the dozens of people I've come to know
living with this disease.
living with this disease.
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e da ducia de persoas que coñecín
que viven con esta doenza.
que viven con esta doenza.
13:28
Diagnosis doesn't mean
you're dying tomorrow.
you're dying tomorrow.
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3184
O diagnóstico non significa
que vaian morrer mañá.
que vaian morrer mañá.
13:31
Keep living.
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1722
Sigan vivindo.
13:33
You won't lose your emotional memory.
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Non han perder a súa memoria emocional.
13:35
You'll still be able
to understand love and joy.
to understand love and joy.
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Aínda poderán entender o amor e a alegría.
13:38
You might not remember
what I said five minutes ago,
what I said five minutes ago,
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Poden non lembrar
o que dixeron hai cinco minutos,
o que dixeron hai cinco minutos,
13:42
but you'll remember how I made you feel.
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mais lembrarán como os fixo sentir.
13:44
And you are more than what
you can remember.
you can remember.
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E vostedes son máis do que lembran.
13:48
Thank you.
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Grazas.
13:49
(Applause)
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(Aplausos)
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