TED2017
Lisa Genova: What you can do to prevent Alzheimer's
Lisa Đenova (Lisa Genova): Kako sprečiti Alchajmerovu bolest
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Alchajmer ne mora biti sudbina vašeg mozga, tvdi neurološkinja i autorka knjige „I dalje Alis", Lisa Đenova. Sa nama je podelila najnovija naučna istraživanja i obećavajuća ispitivanja koja se tiču koraka koje svako od nas može da preduzme kako bismo postali otporniji na Alchajmerovu 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 vas koji ste ovde
bi volelo da doživi bar 80 godina?
bi volelo da doživi bar 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 mi gajimo tu nadu
00:22
of living into old age.
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da ćemo doživeti duboku starost.
00:24
Let's project out into the future,
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Hajde da odemo u budućnost,
00:26
to your future "you's,"
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gde se nalazite budući vi,
00:28
and let's imagine that we're all 85.
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i da zamislimo da svi imamo 85 godina.
00:31
Now, everyone look at two people.
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Sad neka svako od vas
pogleda dve osobe.
pogleda dve osobe.
00:35
One of you probably has
Alzheimer's disease.
Alzheimer's disease.
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Jedna od njih verovatno ima
Alchajmerovu bolest.
Alchajmerovu bolest.
00:39
(Laughter)
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(Smeh)
00:42
Alright, alright.
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Dobro, dobro.
00:44
And maybe you're thinking,
"Well, it won't be me."
"Well, it won't be me."
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Možda i mislite: „Pa, to nisam ja."
00:49
Then, OK. You are a caregiver.
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U redu, onda ste vi staratelj.
00:53
So --
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Tako da...
00:54
(Laughter)
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(Smeh)
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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će ova užasavajuća bolest verovatno
pogoditi svakog od nas.
pogoditi svakog od nas.
01:02
Part of the fear around Alzheimer's
stems from the sense
stems from the sense
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Jednim delom strah od Alchajmera
nastaje iz saznanja
nastaje iz saznanja
01:05
that there's nothing we can do about it.
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da se ništa ne može učiniti.
01:08
Despite decades of research, we still
have no disease-modifying treatment
have no disease-modifying treatment
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Uprskos decenijskim istraživanjima,
još uvek ne postoji tretman,
još uvek ne postoji tretman,
01:13
and no cure.
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niti lek.
01:15
So if we're lucky enough
to live long enough,
to live long enough,
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Tako da, ako budemo imali tu sreću
da poživimo dugo,
da poživimo dugo,
01:17
Alzheimer's appears to be
our brain's destiny.
our brain's destiny.
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izgleda da će Alchajmer biti sudbina
našeg mozga.
našeg mozga.
01:21
But maybe it doesn't have to be.
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Ali možda i ne mora da bude.
01:23
What if I told you we could
change these statistics,
change these statistics,
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Šta ako vam kažem da možemo
da promenimo statistiku,
da promenimo statistiku,
01:26
literally change our brain's destiny,
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da doslovno promenimo sudbinu mozga,
01:29
without relying on a cure
or advancements in medicine?
or advancements in medicine?
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a da se ne oslanjamo na lek,
ni na napredovanja u medicini?
ni na napredovanja u medicini?
01:33
Let's begin by looking at
what we currently understand
what we currently understand
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Počnimo sa razmatranjem
onoga što trenutno znamo
onoga što trenutno znamo
01:36
about the neuroscience of Alzheimer's.
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o neurološkoj strani Alchajmera.
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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Mesto gde se povezuju,
označeno crvenim krugom,
označeno crvenim krugom,
01:46
is called the synapse.
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naziva se sinapsa.
01:47
The synapse is where
neurotransmitters are released.
neurotransmitters are released.
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U sinapsu se ispuštaju neurotransmiteri.
01:51
This is where signals are transmitted,
where communication happens.
where communication happens.
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To je mesto gde se prenose signali,
gde se odigrava komunikacija.
gde se odigrava komunikacija.
01:55
This is where we think,
feel, see, hear, desire ...
feel, see, hear, desire ...
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Tu razmišljamo, osećamo, vidimo,
čujemo, želimo...
čujemo, želimo...
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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I sinapsa je mesto
na koje utiče Alchajmer.
na koje utiče Alchajmer.
02:05
Let's zoom in on the synapse
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Hajde da zumiramo sinapsu,
02:07
and look at a cartoon representation
of what's going on.
of what's going on.
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i da pogledamo grafički prikaz
onoga što se događa.
onoga što se događa.
02:10
During the business
of communicating information,
of communicating information,
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Kada se odigrava razmena informacija,
02:13
in addition to releasing neurotransmitters
like glutamate into the synapse,
like glutamate into the synapse,
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pored ispuštanja neurotransmitera
u sinapsu, kao što je glutamin,
u sinapsu, kao što je glutamin,
02:17
neurons also release a small peptide
called amyloid beta.
called amyloid beta.
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neuroni ispuštaju i mali peptid
koji se zove amiloid beta.
koji se zove amiloid beta.
02:22
Normally, amyloid beta is cleared away
metabolized by microglia,
metabolized by microglia,
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Obično bi amiloid beta bio uklonjen
tako što ga metabolizuju mikroglije,
tako što ga metabolizuju mikroglije,
02:27
the janitor cells of our brains.
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ćelije koje su „domari" našeg mozga.
02:30
While the molecular causes
of Alzheimer's are still debated,
of Alzheimer's are still debated,
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Iako se o molekularnim razlozima
Alchajmera još uvek raspravlja,
Alchajmera još uvek raspravlja,
02:34
most neuroscientists believe
that the disease begins
that the disease begins
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većina neuronaučnika veruje
da se bolest aktivira
da se bolest aktivira
02:37
when amyloid beta begins to accumulate.
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kada amiloid beta počne da se gomila.
02:40
Too much is released,
or not enough is cleared away,
or not enough is cleared away,
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Previše se ispusti,
ili se premalo ukloni,
ili se premalo ukloni,
02:43
and the synapse begins
to pile up with amyloid beta.
to pile up with amyloid beta.
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i u sinapsi počne da se nagomilava
amiloid beta.
amiloid beta.
02:47
And when this happens, it binds to itself,
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A kada do toga dođe,
vezuju se jedan za drugog,
vezuju se jedan za drugog,
02:49
forming sticky aggregates
called amyloid plaques.
called amyloid plaques.
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stvarajući lepljivu masu
ili takozvane amiloidne naslage.
ili takozvane amiloidne naslage.
02:53
How many people here
are 40 years old or older?
are 40 years old or older?
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Koliko vas koji ste ovde
ima 40 godina ili više?
ima 40 godina ili više?
02:57
You're afraid to admit it now.
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Sad se plašite da priznate.
02:59
This initial step into the disease,
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Prvi znak koji vodi ka bolesti,
03:01
this presence of amyloid
plaques accumulating,
plaques accumulating,
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prisustvo amilodnih naslaga
koje se nagomilavaju,
koje se nagomilavaju,
03:05
can already be found in your brains.
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već se može naći 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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To jedino možemo da potvrdimo
ako se uradi PET snimak,
ako se uradi PET snimak,
03:11
because at this point,
you are blissfully unaware.
you are blissfully unaware.
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jer sada živite u blaženom neznanju.
03:15
You're not showing any impairments
in memory, language, or cognition ...
in memory, language, or cognition ...
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Ne pokazujete znake oštećenja pamćenja,
jezika ili razumevanja...
jezika ili razumevanja...
03:19
yet.
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Još uvek.
03:21
We think it takes at least 15 to 20 years
of amyloid plaque accumulation
of amyloid plaque accumulation
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Smatramo da je potrebno da prođe 15 do 20
godina nagomilavanja amiloidnih naslaga
godina nagomilavanja amiloidnih naslaga
03:26
before it reaches a tipping point,
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da bi se došlo do prelomne tačke,
03:28
then triggering a molecular cascade
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što bi aktiviralo molekularne reakcije,
03:30
that causes the clinical
symptoms of the disease.
symptoms of the disease.
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i dovelo do ispoljavanja kliničkih
simptoma bolesti.
simptoma bolesti.
03:33
Prior to the tipping point,
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Pre prelomne tačke,
03:35
your lapses in memory
might include things like,
might include things like,
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vaši gubici u memoriji mogu biti
stvari kao što su:
stvari kao što su:
03:39
"Why did I come in this room?"
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„Zašto sam došla u ovu sobu?"
03:41
or "Oh ... what's his name?"
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Ili „...Kako se on zove?"
03:44
or "Where did I put my keys?"
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Ili „Gde sam ostavila ključeve?"
03:47
Now, before you all
start freaking out again,
start freaking out again,
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Pre nego što svi počnete da paničite,
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 se skoro svima dogodila makar
jedna od ovih stvari u poslednja 24 časa,
jedna od ovih stvari u poslednja 24 časa,
03:55
these are all normal kinds of forgetting.
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to su sve normalne vrste zaboravljanja.
03:58
In fact, I would argue that these examples
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Zapravo, sigurna sam da se ovi primeri
04:01
might not even involve your memory,
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čak i ne tiču vašeg pamćenja,
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 prvenstveno, niste obraćali pažnju
04:06
in the first place.
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gde ste spustili ključeve.
04:07
After the tipping point,
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Nakon prelomne tačke,
04:09
the glitches in memory,
language and cognition are different.
language and cognition are different.
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propusti u pamćenju, jeziku
i razumevanju su drugačiji.
i razumevanju su drugačiji.
04:12
Instead of eventually finding
your keys in your coat pocket
your keys in your coat pocket
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Umesto da pronađete ključeve
u džepu kaputa,
u džepu kaputa,
04:15
or on the table by the door,
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ili na stolu pored vrata,
04:17
you find them in the refrigerator,
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pronađete ih u frižideru
04:20
or you find them and you think,
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ili ih pronađete i pomislite:
04:22
"What are these for?"
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„Za šta su ovi ključevi?"
04:24
So what happens when amyloid plaques
accumulate to this tipping point?
accumulate to this tipping point?
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Šta se dešava kada se amiloidne naslage
nagomilaju do prelomne tačke?
nagomilaju do prelomne tačke?
04:30
Our microglia janitor cells
become hyper-activated,
become hyper-activated,
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Naši domari mikroglije postaju
hiperaktivni,
hiperaktivni,
04:33
releasing chemicals that cause
inflammation and cellular damage.
inflammation and cellular damage.
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i oslobađaju hemikalije koje uzrokuju
upale i ćelijska oštećenja.
upale i ćelijska oštećenja.
04:37
We think they might actually
start clearing away
start clearing away
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Mislimo da čak počinju da uklanjaju
04:40
the synapses themselves.
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i same sinapse.
04:42
A crucial neural transport protein
called "tau" becomes hyperphosphorylated
called "tau" becomes hyperphosphorylated
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Dolazi do hiperfosforilacije bitnog neuro
transportnog proteina „tau",
transportnog proteina „tau",
04:46
and twists itself
into something called "tangles,"
into something called "tangles,"
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koji se savija u nešto što se zove čvor
04:49
which choke off the neurons
from the inside.
from the inside.
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i ubija 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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Kad Alchajmer stigne do srednje faze,
dolazi do teških zapaljenja i čvorova,
dolazi do teških zapaljenja i čvorova,
04:56
and all-out war at the synapse
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i sveopšteg napada na sinapsu,
04:58
and cell death.
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i odumiranja ćelija.
05:00
So if you were a scientist
trying to cure this disease,
trying to cure this disease,
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Ako ste vi naučnik koji pokušava
da izleči ovu bolest,
da izleči ovu bolest,
05:03
at what point would you ideally
want to intervene?
want to intervene?
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tokom koje faze bi bilo najbolje
da intervenišete?
da intervenišete?
05:07
Many scientists are betting big
on the simplest solution:
on the simplest solution:
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Mnogi naučnici se klade
na najjednostavnije rešenje:
na najjednostavnije rešenje:
05:11
keep amyloid plaques
from reaching that tipping point,
from reaching that tipping point,
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sprečiti amiloidne pločice da dođu do
prelomne tačke,
prelomne tačke,
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 istraživanje za lek
fokusirano na razvijanje jedinjenja
fokusirano na razvijanje jedinjenja
05:18
that will prevent, eliminate, or reduce
amyloid plaque accumulation.
amyloid plaque accumulation.
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koje će sprečiti, ukloniti ili smanjiti
gomilanje amiloidnih pločica.
gomilanje amiloidnih pločica.
05:24
So the cure for Alzheimer's will likely be
a preventative medicine.
a preventative medicine.
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Tako da će to verovatno biti preventivni
lek za Alchajmer.
lek za Alchajmer.
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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Moraćemo da uzimamo tabletu pre nego što
dođemo do prelomne tačke,
dođemo do prelomne tačke,
05:33
before the cascade is triggered,
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pre nego što se pokrene urušavanje,
05:35
before we start leaving
our keys in the refrigerator.
our keys in the refrigerator.
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pre nego što počnemo da ostavljamo
ključeve u frižideru.
ključeve u frižideru.
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 zato lekovi koji se koriste
danas nemaju dejstva
danas nemaju dejstva
05:43
in clinical trials --
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u kliničkim ispitivanjima,
05:44
not because the science wasn't sound,
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ne zato što nauka nije ispravna,
05:46
but because the people in these trials
were already symptomatic.
were already symptomatic.
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nego zato što su ljudi koji su ispitivani
već pokazivali simptome bolesti.
već pokazivali simptome bolesti.
05:50
It was too late.
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I već je bilo kasno.
05:52
Think of amyloid plaques as a lit match.
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Mislite o amiloidnim pločicama
kao o zapaljenoj šibici.
kao o zapaljenoj šibici.
05:55
At the tipping point, the match
sets fire to the forest.
sets fire to the forest.
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Na prelomnoj tački,
šibica je zapalila šumu.
šibica je zapalila šumu.
05:59
Once the forest is ablaze,
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Kada se šuma zapali,
06:01
it doesn't do any good
to blow out the match.
to blow out the match.
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više nema potrebe gasiti šibicu.
06:04
You have to blow out the match
before the forest catches fire.
before the forest catches fire.
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Ona mora da se ugasi pre nego što
šumu zahvati plamen.
šumu zahvati plamen.
06:08
Even before scientists sort this out,
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Dok naučnici to razreše,
06:10
this information is actually
really good news for us,
really good news for us,
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ovo je zapravo dobra informacija 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 ispostavilo da naš način života
utiče na nagomilavanje
utiče na nagomilavanje
06:17
of amyloid plaques.
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amiloidnih pločica.
06:18
And so there are things we can do
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Tako da ima stvari koje možemo uraditi
06:20
to keep us from reaching
that tipping point.
that tipping point.
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kako ne bismo stigli do prelomne tačke.
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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Hajde da predstavimo
rizik od Alchajmera na klackalici.
rizik od Alchajmera na klackalici.
Na jednu stranu ćemo staviti
rizične faktore,
rizične faktore,
06:27
We're going to pile
risk factors on one arm,
risk factors on one arm,
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06:29
and when that arm hits the floor,
you are symptomatic
you are symptomatic
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i kada ona dođe do zemlje,
ispoljavate simptome,
ispoljavate simptome,
06:31
and diagnosed with Alzheimer's.
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i imate Alchajmera.
06:34
Let's imagine you're 50 years old.
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Recimo da imate 50 godina.
06:36
You're not a spring chicken anymore,
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Niste više tako mladi,
06:38
so you've accumulated
some amyloid plaques with age.
some amyloid plaques with age.
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i sa godinama su se nagomilale
amiloidne pločice.
amiloidne pločice.
06:41
Your scale is tipped a little bit.
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Klackalica se malo nagla.
06:44
Now let's look at your DNA.
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Sad pogledajmo vaš 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 nasledili gene od 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 njih povećavaju rizik,
a neki ga umanjuju.
a neki ga umanjuju.
06:54
If you're like Alice in "Still Alice,"
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Ako ste kao Alis u „I dalje Alis",
06:56
you've inherited a rare genetic mutation
that cranks out amyloid beta,
that cranks out amyloid beta,
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nasledili ste retku genetsku mutaciju
koja ispušta mnogo amiloid bete,
koja ispušta mnogo amiloid bete,
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 zbog toga će vaša klackalica
dotaći pod.
dotaći pod.
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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Ali za većinu, geni koje smo nasledili
će je samo malo nagnuti.
će je samo malo nagnuti.
07:08
For example, APOE4 is a gene variant
that increases amyloid,
that increases amyloid,
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Na primer, APOE4 je varijanta gena
koja povećava amiloide,
koja povećava amiloide,
07:13
but you can inherit a copy of APOE4
from mom and dad
from mom and dad
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ali možete naslediti kopiju APOE4
od majke i oca,
od majke i oca,
07:16
and still never get Alzheimer's,
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a da nikada ne obolite od Alchajmera,
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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DNK nije jedini koji određuje da li ćemo
oboleti od Alchajmera.
oboleti od Alchajmera.
07:25
So what does?
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Šta 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 da uradimo ništa povodom
starenja ili gena koje smo nasledili.
starenja ili gena koje smo nasledili.
07:31
So far, we haven't changed
our brain's destiny.
our brain's destiny.
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Još uvek nismo izmenili sudbinu
našega mozga.
našega mozga.
07:35
What about sleep?
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Šta je sa snom?
07:37
In slow-wave deep sleep, our glial cells
rinse cerebral spinal fluid
rinse cerebral spinal fluid
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U dubokom snu sporih talasa,
naše glijalne ćelije ispiraju naš mozak
naše glijalne ćelije ispiraju naš mozak
tečnošču iz kičmene moždine
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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i čiste sav metabolički otpad
koji se nagomilao u našim sinapsama
koji se nagomilao 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
kao čišćenje pod pritiskom.
kao čišćenje pod pritiskom.
07:51
But what happens if you shortchange
yourself on sleep?
yourself on sleep?
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Ali šta se dešava
ako sami sebe zakidate na snu?
ako sami sebe zakidate na snu?
07:55
Many scientists believe
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Mnogi naučnici veruju
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 loš san zapravo može biti rani znak
nastajanja Alchajmera.
nastajanja Alchajmera.
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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Jedna noć manjka sna dovodi
do povećanja amiloida beta.
do povećanja amiloida beta.
08:07
And amyloid accumulation
has been shown to disrupt sleep,
has been shown to disrupt sleep,
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Dokazano je da nagomilavanje amiloida
izaziva poremećaje spavanja,
izaziva poremećaje spavanja,
08:10
which in turn causes
more amyloid to accumulate.
more amyloid to accumulate.
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što dalje prouzrokuje
još skupljanja amiloida.
još skupljanja amiloida.
08:13
And so now we have
this positive feedback loop
this positive feedback loop
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Sada imamo ovu pozitivnu petlju
koja se nastavlja
koja se nastavlja
08:15
that's going to accelerate
the tipping of that scale.
the tipping of that scale.
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i koja ubrzava neravnotežu.
08:19
What else?
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Šta još?
08:20
Cardiovascular health.
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Kardiovaskularno zdravlje.
08:23
High blood pressure, diabetes,
obesity, smoking, high cholesterol,
obesity, smoking, high cholesterol,
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Visok krvni pritisak, dijabetes,
gojaznost, pušenje, visok holesterol,
gojaznost, pušenje, visok holesterol,
08:26
have all been shown to increase our risk
of developing Alzheimer's.
of developing Alzheimer's.
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za sve je dokazano da povećavaju rizik
nastanka Alchajmera.
nastanka Alchajmera.
08:30
Some autopsy studies have shown
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Neke autopsije 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 do 80% ljudi sa Alchajmerom
08:35
also had cardiovascular disease.
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takođe ima kardiovaskularne bolesti.
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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Dokazano je da aerobičke vežbe
smanjuju amiloid beta
smanjuju amiloid beta
08:43
in animal models of the disease.
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u istraživanjima sa životinjama.
08:45
So a heart-healthy
Mediterranean lifestyle and diet
Mediterranean lifestyle and diet
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Mediteranski stil života i ishrana
sa zdravim srcem mogu pomoći
sa zdravim srcem mogu pomoći
08:49
can help to counter
the tipping of this scale.
the tipping of this scale.
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da se uspori razvoj bolesti.
08:52
So there are many things we can do
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Postoje mnoge stvari
koje možemo da uradimo
koje možemo da uradimo
kako bismo sprečili ili odložili
nastanak Alchajmera.
nastanak Alchajmera.
08:55
to prevent or delay
the onset of Alzheimer's.
the onset of Alzheimer's.
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08:57
But let's say
you haven't done any of them.
you haven't done any of them.
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Ali recimo da niste uradili
bilo šta od toga.
bilo šta od toga.
09:00
Let's say you're 65;
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Recimo 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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u vašoj porodici ima bolesti,
verovatno ste nasledili gen ili dva
verovatno ste nasledili gen ili dva
09:06
that tips your scale arm a bit;
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koji će malo iskriviti klackalicu,
09:08
you've been burning the candle
at both ends for years;
at both ends for years;
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gorite sveću sa oba kraja
već godinama;
već godinama;
09:11
you love bacon;
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obožavate slaninu;
09:12
and you don't run unless
someone's chasing you.
someone's chasing you.
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ne trčite osim ako vas neko juri.
09:14
(Laughter)
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(Smeh)
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 vaše naslage amiloida
dostigle tu kritičnu tačku.
dostigle tu kritičnu tačku.
09:19
Your scale arm has crashed to the floor.
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Kazaljka na vagi pala je na pod.
09:21
You've tripped the cascade,
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Pokrenuli ste slap,
09:23
setting fire to the forest,
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zapalili šumu
09:25
causing inflammation, tangles,
and cell death.
and cell death.
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i doveli do upale, mršenja
i umiranja ćelija.
i umiranja ćelija.
09:29
You should be symptomatic for Alzheimer's.
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Trebalo bi da imate simptome Alchajmera.
09:31
You should be having trouble
finding words and keys
finding words and keys
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Trebalo bi da imate problema
da pronađete reči i ključeve
da pronađete reči i ključeve
09:35
and remembering what I said
at the beginning of this talk.
at the beginning of this talk.
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i setite se onoga što sam rekla
na početku ovog govora.
na početku ovog govora.
09:38
But you might not be.
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Ali možda i ne.
Postoji još nešto što možete uraditi
kako biste se zaštitili
kako biste se zaštitili
09:41
There's one more thing you can do
to protect yourself
to protect yourself
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09:43
from experiencing
the symptoms of Alzheimer's,
the symptoms of Alzheimer's,
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od simptoma Alchajmera,
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 imate razvijenu patologiju
bolesti u svom mozgu.
bolesti u svom mozgu.
09:50
It has to do with neural plasticity
and cognitive reserve.
and cognitive reserve.
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Ima veze sa neuronskom plastičnošću
i kognitivnim rezervama.
i kognitivnim rezervama.
09:55
Remember, the experience
of having Alzheimer's
of having Alzheimer's
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Prisetite se da je doživljaj Alchajmera
09:57
is ultimately a result of losing synapses.
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na kraju samo posledica
gubljenja sinapsi.
gubljenja sinapsi.
10:01
The average brain has
over a hundred trillion synapses,
over a hundred trillion synapses,
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Prosečan mozak ima preko
sto triliona sinapsi,
sto triliona sinapsi,
što je fantastično, imamo dosta toga
sa čime možemo da radimo.
sa čime možemo da radimo.
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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10:07
And this isn't a static number.
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A ovo nije fiksiran broj.
10:09
We gain and lose synapses all the time,
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Stalno dobijamo i gubimo sinapse,
10:11
through a process
called neural plasticity.
called neural plasticity.
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kroz proces zvani
neuronska plastičnost.
neuronska plastičnost.
10:14
Every time we learn something new,
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Svaki put kada naučimo nešto novo,
10:16
we are creating and strengthening
new neural connections,
new neural connections,
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stvaramo i ojačavamo
nove neuronske veze,
nove neuronske veze,
10:20
new synapses.
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nove sinapse.
10:22
In the Nun Study,
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U istraživanju sa kaluđericama,
10:24
678 nuns, all over the age of 75
when the study began,
when the study began,
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678 kaluđerica, sve starije od 75 godina
u vreme početka istraživanja,
u vreme početka istraživanja,
10:29
were followed for more than two decades.
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praćene su više od dve decenije.
10:31
They were regularly given
physical checkups and cognitive tests,
physical checkups and cognitive tests,
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Redovno su imale lekarske preglede
i kognitivna ispitivanja
i kognitivna ispitivanja
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, njihovi mozgovi
donirani su za autopsiju.
donirani su za autopsiju.
10:39
In some of these brains, scientists
discovered something surprising.
discovered something surprising.
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U nekim od ovih mozgova,
naučnici su otkrili nešto iznenađujuće.
naučnici su otkrili nešto iznenađujuće.
10:43
Despite the presence of plaques
and tangles and brain shrinkage --
and tangles and brain shrinkage --
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Uprkos prisustvu naslaga i čvorova
i smanjenju mozga -
i smanjenju mozga -
10:48
what appeared to be
unquestionable Alzheimer's --
unquestionable Alzheimer's --
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što je bez pogovora bio Alchajmer -
10:51
the nuns who had belonged
to these brains showed no signs
to these brains showed no signs
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kaluđerice koje su imale ove mozgove
nisu pokazivale nikakve znakove toga
nisu pokazivale nikakve znakove toga
10:54
of having the disease
while they were alive.
while they were alive.
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da su imale bolest dok su bile žive.
10:58
How can this be?
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Kako je ovo 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 zato što su ove kaluđerice
imale velike kognitivne rezerve,
imale velike kognitivne rezerve,
11:04
which is a way of saying that they had
more functional synapses.
more functional synapses.
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što je drugi način da se kaže
da su imale funkcionalnije sinapse.
da su imale funkcionalnije sinapse.
11:08
People who have more years
of formal education,
of formal education,
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Ljudi koji imaju više godina
formalnog obrazovanja,
formalnog obrazovanja,
11:10
who have a high degree of literacy,
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koji imaju viši nivo pismenosti,
11:12
who engage regularly
in mentally stimulating activities,
in mentally stimulating activities,
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koji se redovno bave aktivnostima
koje stimulišu mentalno,
koje stimulišu mentalno,
11:16
all have more cognitive reserve.
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svi imaju 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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Imaju obilje i višak nervnih veza.
11:23
So even if they have a disease
like Alzheimer's
like Alzheimer's
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Tako da čak i ako imaju bolest
poput Alchajmera
poput Alchajmera
11:25
compromising some of their synapses,
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koja kompromituje neke
od njihovih sinapsi,
od njihovih sinapsi,
11:28
they've got many extra backup connections,
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imaju mnogo dodatnih rezervnih veza
11:31
and this buffers them from noticing
that anything is amiss.
that anything is amiss.
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i ovo ih sprečava da primete
da se nešto loše dešava.
da se nešto loše dešava.
11:34
Let's imagine a simplified example.
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Uzmimo pojednostavljen primer.
11:37
Let's say you only know one thing
about a subject.
about a subject.
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Recimo da znate samo jednu stvar o nečemu.
11:40
Let's say it's about me.
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Recimo da je to o meni.
11:41
You know that Lisa Genova
wrote "Still Alice,"
wrote "Still Alice,"
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Znate da je Lisa Đenova
napisala "I dalje Alis",
napisala "I dalje Alis",
11:43
and that's the only thing
you know about me.
you know about me.
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i to je jedina stvar koju znate o meni.
11:46
You have that single neural connection,
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Imate tu jednu nervnu vezu,
11:48
that one synapse.
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jednu sinapsu.
11:50
Now imagine you have Alzheimer's.
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Sada zamislite da imate Alchajmera.
11:52
You have plaques and tangles
and inflammation
and inflammation
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Imate naslage i čvorove i upale
11:55
and microglia devouring that synapse.
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i mikroglije koji napadaju tu sinapsu.
11:58
Now when someone asks you,
"Hey, who wrote 'Still Alice?'"
"Hey, who wrote 'Still Alice?'"
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Sada kada vas neko pita:
"Hej, ko je napisao 'I dalje Alis?'",
"Hej, ko je napisao 'I dalje Alis?'",
12:02
you can't remember,
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ne možete da se setite,
12:04
because that synapse
is either failing or gone.
is either failing or gone.
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jer ta sinapsa ili propada,
ili je nestala.
ili je nestala.
12:07
You've forgotten me forever.
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Zaboravili ste me zauvek.
12:09
But what if you had learned more about me?
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Ali šta kada biste saznali više o meni?
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 imate Alchajmera
12:16
and three of those synapses
are damaged or destroyed.
are damaged or destroyed.
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i da se oštete ili unište tri te sinapse.
12:20
You still have a way
to detour the wreckage.
to detour the wreckage.
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Još uvek imate način da ispravite štetu.
12:22
You can still remember my name.
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Još se sećate 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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Možemo biti otporni na prisustvo
patologije Alchajmera
patologije Alchajmera
12:29
through the recruitment
of yet-undamaged pathways.
of yet-undamaged pathways.
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kroz regrutovanje onih putanja
koje još nisu oštećene.
koje još nisu oštećene.
12:32
And we create these pathways,
this cognitive reserve,
this cognitive reserve,
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Mi stvaramo te putanje,
te kognitivne rezerve,
te kognitivne rezerve,
12:36
by learning new things.
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tako što 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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Idealno bi bilo da te nove stvari
budu što bogatije u značenju
budu što bogatije u značenju
12:43
recruiting sight and sound
and associations and emotion.
and associations and emotion.
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i da angažuju vid i sluh
i asocijacije i emocije.
i asocijacije i emocije.
12:48
So this really doesn't mean
doing crossword puzzles.
doing crossword puzzles.
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Ovo ne podrazumeva da rešavamo ukrštenice.
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 da prosto posežete
za već naučenim informacijama
za već naučenim informacijama
12:55
because this is like traveling
down old, familiar streets,
down old, familiar streets,
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jer je ovo poput putovanja
starim, poznatim ulicama,
starim, poznatim ulicama,
12:59
cruising neighborhoods you already know.
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prolaženja krajevima koje već znate.
13:02
You want to pave new neural roads.
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Želite da stvarate nove nervne puteve.
13:04
Building an Alzheimer's-resistant brain
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Pravljenje mozga otpornog na Alchajmera
13:07
means learning to speak Italian,
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podrazumeva da učite italijanski,
13:09
meeting new friends,
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upoznajete nove prijatelje,
13:11
reading a book,
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čitate knjige
13:12
or listening to a great TED Talk.
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ili slušate sjajan 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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5313
Ako uprkos svemu ovome jednog dana
imate dijagnozu Alchajmera,
imate dijagnozu Alchajmera,
13:20
there are three lessons I've learned
from my grandmother
from my grandmother
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3153
postoje tri lekcije koje sam naučila
od moje bake
od moje 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 desetine ljudi koje sam upoznala
koji žive sa ovom bolešću.
koji žive sa 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 umreti.
13:31
Keep living.
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Nastavite da živite.
13:33
You won't lose your emotional memory.
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Nećete izgubiti svoje emotivno pamćenje.
13:35
You'll still be able
to understand love and joy.
to understand love and joy.
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Moći ćete da razumete 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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3003
Možda se nećete sećati onoga
što sam rekla pre pet minuta,
što sam rekla pre pet minuta,
13:42
but you'll remember how I made you feel.
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ali ćete se sećati toga kako sam vas
naterala da se osećate.
naterala da se osećate.
13:44
And you are more than what
you can remember.
you can remember.
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Vi ste više od onoga
čega možete da se prisetite.
čega možete da se prisetite.
13:48
Thank you.
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Hvala vam.
13:49
(Applause)
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5323
(Aplauz)
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