[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:01.12,0:00:06.34,Default,,0000,0000,0000,,How many people here would like to live\Nto be at least 80 years old?
Dialogue: 0,0:00:06.34,0:00:07.96,Default,,0000,0000,0000,,Yeah.
Dialogue: 0,0:00:07.96,0:00:10.62,Default,,0000,0000,0000,,I think we all have\Nthis hopeful expectation
Dialogue: 0,0:00:10.62,0:00:12.83,Default,,0000,0000,0000,,of living into old age.
Dialogue: 0,0:00:12.83,0:00:15.14,Default,,0000,0000,0000,,Let's project out into the future,
Dialogue: 0,0:00:15.14,0:00:16.72,Default,,0000,0000,0000,,to your future yous,
Dialogue: 0,0:00:16.72,0:00:19.60,Default,,0000,0000,0000,,and let's imagine that we're all 85.
Dialogue: 0,0:00:19.60,0:00:22.85,Default,,0000,0000,0000,,Now everyone look at two people.
Dialogue: 0,0:00:22.85,0:00:27.13,Default,,0000,0000,0000,,One of you probably has\NAlzheimer's disease.
Dialogue: 0,0:00:30.81,0:00:32.67,Default,,0000,0000,0000,,Alright, alright.
Dialogue: 0,0:00:32.67,0:00:35.19,Default,,0000,0000,0000,,And maybe you're thinking, well,
Dialogue: 0,0:00:35.19,0:00:37.56,Default,,0000,0000,0000,,it won't be me.
Dialogue: 0,0:00:37.56,0:00:41.37,Default,,0000,0000,0000,,Then, okay, you are a caregiver.
Dialogue: 0,0:00:45.47,0:00:47.04,Default,,0000,0000,0000,,So in some way,
Dialogue: 0,0:00:47.04,0:00:50.93,Default,,0000,0000,0000,,this terrifying disease\Nis likely to affect us all.
Dialogue: 0,0:00:50.93,0:00:53.97,Default,,0000,0000,0000,,Part of the fear around Alzheimer's\Nstems from the sense
Dialogue: 0,0:00:53.97,0:00:56.41,Default,,0000,0000,0000,,that there's nothing we can do about it.
Dialogue: 0,0:00:56.41,0:01:01.56,Default,,0000,0000,0000,,Despite decades of research, we still\Nhave no disease-modifying treatment
Dialogue: 0,0:01:01.56,0:01:03.40,Default,,0000,0000,0000,,and no cure.
Dialogue: 0,0:01:03.40,0:01:05.81,Default,,0000,0000,0000,,So if we're lucky enough\Nto live long enough,
Dialogue: 0,0:01:05.81,0:01:09.54,Default,,0000,0000,0000,,Alzheimer's appears to be\Nour brain's destiny.
Dialogue: 0,0:01:09.54,0:01:11.65,Default,,0000,0000,0000,,But maybe it doesn't have to be.
Dialogue: 0,0:01:11.65,0:01:15.38,Default,,0000,0000,0000,,What if I told you we could\Nchange these statistics,
Dialogue: 0,0:01:15.38,0:01:17.69,Default,,0000,0000,0000,,literally change our brain's destiny,
Dialogue: 0,0:01:17.69,0:01:22.12,Default,,0000,0000,0000,,without relying on a cure\Nor advancements in medicine?
Dialogue: 0,0:01:22.12,0:01:24.58,Default,,0000,0000,0000,,Let's begin by looking at\Nwhat we currently understand
Dialogue: 0,0:01:24.58,0:01:27.49,Default,,0000,0000,0000,,about the neuroscience of Alzheimer's.
Dialogue: 0,0:01:27.49,0:01:30.76,Default,,0000,0000,0000,,Here's a picture\Nof two neurons connecting.
Dialogue: 0,0:01:30.76,0:01:34.14,Default,,0000,0000,0000,,The point of connection,\Nthis space circled in red,
Dialogue: 0,0:01:34.14,0:01:35.81,Default,,0000,0000,0000,,is called the synapse.
Dialogue: 0,0:01:35.81,0:01:39.02,Default,,0000,0000,0000,,The synapse is where\Nneurotransmitters are released.
Dialogue: 0,0:01:39.02,0:01:41.31,Default,,0000,0000,0000,,This is where signals are transmitted,
Dialogue: 0,0:01:41.31,0:01:43.60,Default,,0000,0000,0000,,where communication happens.
Dialogue: 0,0:01:43.60,0:01:45.64,Default,,0000,0000,0000,,This is where we think,
Dialogue: 0,0:01:45.64,0:01:48.44,Default,,0000,0000,0000,,feel, see, hear, desire,
Dialogue: 0,0:01:48.44,0:01:50.27,Default,,0000,0000,0000,,and remember.
Dialogue: 0,0:01:50.27,0:01:53.18,Default,,0000,0000,0000,,And the synapse\Nis where Alzheimer's happens.
Dialogue: 0,0:01:53.18,0:01:55.17,Default,,0000,0000,0000,,Let's zoom in on the synapse
Dialogue: 0,0:01:55.17,0:01:58.92,Default,,0000,0000,0000,,and look at a cartoon representation\Nof what's going on.
Dialogue: 0,0:01:58.92,0:02:01.18,Default,,0000,0000,0000,,During the business\Nof communicating information,
Dialogue: 0,0:02:01.18,0:02:05.06,Default,,0000,0000,0000,,in addition to releasing neurotransmitters\Nlike glutamate into the synapse,
Dialogue: 0,0:02:05.06,0:02:07.65,Default,,0000,0000,0000,,neurons also release a small peptide
Dialogue: 0,0:02:07.65,0:02:10.19,Default,,0000,0000,0000,,called amyloid beta.
Dialogue: 0,0:02:10.19,0:02:15.62,Default,,0000,0000,0000,,Normally, amyloid beta is cleared away\Nand metabolized by microglia,
Dialogue: 0,0:02:15.62,0:02:18.17,Default,,0000,0000,0000,,the janitor cells of our brains.
Dialogue: 0,0:02:18.17,0:02:22.03,Default,,0000,0000,0000,,While the molecular causes\Nof Alzheimer's are still debated,
Dialogue: 0,0:02:22.03,0:02:25.57,Default,,0000,0000,0000,,most neuroscientists believe\Nthat the disease begins
Dialogue: 0,0:02:25.57,0:02:28.78,Default,,0000,0000,0000,,when amyloid beta begins to accumulate.
Dialogue: 0,0:02:28.78,0:02:31.74,Default,,0000,0000,0000,,Too much is released,\Nor not enough is cleared away,
Dialogue: 0,0:02:31.74,0:02:35.10,Default,,0000,0000,0000,,and the synapse begins\Nto pile up with amyloid beta.
Dialogue: 0,0:02:35.10,0:02:37.52,Default,,0000,0000,0000,,And when this happens, it binds to itself,
Dialogue: 0,0:02:37.52,0:02:41.53,Default,,0000,0000,0000,,forming sticky aggregates\Ncalled amyloid plaques.
Dialogue: 0,0:02:41.53,0:02:45.18,Default,,0000,0000,0000,,How many people here\Nare 40 years old or older?
Dialogue: 0,0:02:45.18,0:02:48.31,Default,,0000,0000,0000,,You're afraid to admit it now.
Dialogue: 0,0:02:48.31,0:02:50.13,Default,,0000,0000,0000,,This initial step into the disease,
Dialogue: 0,0:02:50.13,0:02:52.98,Default,,0000,0000,0000,,this presence of amyloid\Nplaques accumulating,
Dialogue: 0,0:02:52.98,0:02:56.43,Default,,0000,0000,0000,,can already be found in your brains.
Dialogue: 0,0:02:56.43,0:02:58.81,Default,,0000,0000,0000,,Now, the only way we could\Nbe sure of this would be
Dialogue: 0,0:02:58.81,0:03:00.74,Default,,0000,0000,0000,,through a PET scan, because at this point,
Dialogue: 0,0:03:00.74,0:03:03.60,Default,,0000,0000,0000,,you are blissfully unaware.
Dialogue: 0,0:03:03.60,0:03:08.05,Default,,0000,0000,0000,,You're not showing any impairments\Nin memory, language, or cognition
Dialogue: 0,0:03:08.05,0:03:09.47,Default,,0000,0000,0000,,yet.
Dialogue: 0,0:03:09.47,0:03:14.03,Default,,0000,0000,0000,,We think it takes at least 15 to 20 years\Nof amyloid plaque accumulation
Dialogue: 0,0:03:14.03,0:03:16.25,Default,,0000,0000,0000,,before it reaches a tipping point,
Dialogue: 0,0:03:16.25,0:03:18.70,Default,,0000,0000,0000,,then triggering a molecular cascade
Dialogue: 0,0:03:18.70,0:03:21.81,Default,,0000,0000,0000,,that causes the clinical\Nsymptoms of the disease.
Dialogue: 0,0:03:21.81,0:03:23.69,Default,,0000,0000,0000,,Prior to the tipping point,
Dialogue: 0,0:03:23.69,0:03:26.61,Default,,0000,0000,0000,,your lapses in memory\Nmight include things like,
Dialogue: 0,0:03:26.61,0:03:29.46,Default,,0000,0000,0000,,"Why did I come in this room?"
Dialogue: 0,0:03:29.46,0:03:32.19,Default,,0000,0000,0000,,or "Oh, what's his name?"
Dialogue: 0,0:03:32.19,0:03:35.44,Default,,0000,0000,0000,,or "Where did I put my keys?"
Dialogue: 0,0:03:35.44,0:03:39.42,Default,,0000,0000,0000,,Yeah, now before you all\Nstart freaking out again,
Dialogue: 0,0:03:39.42,0:03:40.64,Default,,0000,0000,0000,,because I know half of you
Dialogue: 0,0:03:40.64,0:03:42.98,Default,,0000,0000,0000,,did at least one of those\Nin the last 24 hours,
Dialogue: 0,0:03:42.98,0:03:46.82,Default,,0000,0000,0000,,these are all normal kinds of forgetting.
Dialogue: 0,0:03:46.82,0:03:49.15,Default,,0000,0000,0000,,In fact, I would argue that these examples
Dialogue: 0,0:03:49.15,0:03:51.15,Default,,0000,0000,0000,,might not even involve your memory,
Dialogue: 0,0:03:51.15,0:03:52.63,Default,,0000,0000,0000,,because you didn't pay attention
Dialogue: 0,0:03:52.63,0:03:55.61,Default,,0000,0000,0000,,to where you put your keys\Nin the first place.
Dialogue: 0,0:03:55.61,0:03:57.31,Default,,0000,0000,0000,,After the tipping point,
Dialogue: 0,0:03:57.31,0:03:59.52,Default,,0000,0000,0000,,the glitches in memory,\Nlanguage, and cognition are different.
Dialogue: 0,0:03:59.52,0:04:03.61,Default,,0000,0000,0000,,Instead of eventually finding\Nyour keys in your coat pocket,
Dialogue: 0,0:04:03.61,0:04:05.51,Default,,0000,0000,0000,,or on the table by the door,
Dialogue: 0,0:04:05.51,0:04:08.54,Default,,0000,0000,0000,,you find them in the refrigerator,
Dialogue: 0,0:04:08.54,0:04:10.37,Default,,0000,0000,0000,,or you find them and you think,
Dialogue: 0,0:04:10.37,0:04:12.67,Default,,0000,0000,0000,,"What are these for?"
Dialogue: 0,0:04:12.67,0:04:16.36,Default,,0000,0000,0000,,Okay, so what happens\Nwhen amyloid plaques
Dialogue: 0,0:04:16.36,0:04:18.22,Default,,0000,0000,0000,,accumulate to this tipping point?
Dialogue: 0,0:04:18.22,0:04:21.56,Default,,0000,0000,0000,,Our microglia janitor cells\Nbecome hyper-activated,
Dialogue: 0,0:04:21.56,0:04:25.72,Default,,0000,0000,0000,,releasing chemicals that cause\Ninflammation and cellular damage.
Dialogue: 0,0:04:25.72,0:04:28.20,Default,,0000,0000,0000,,We think they might actually\Nstart clearing away
Dialogue: 0,0:04:28.20,0:04:30.62,Default,,0000,0000,0000,,the synapses themselves.
Dialogue: 0,0:04:30.62,0:04:33.65,Default,,0000,0000,0000,,A crucial neural transport protein\Ncalled tau becomes hyperphosphorylated
Dialogue: 0,0:04:33.65,0:04:37.48,Default,,0000,0000,0000,,and twists itself\Ninto something called tangles
Dialogue: 0,0:04:37.48,0:04:40.44,Default,,0000,0000,0000,,which choke off the neurons\Nfrom the inside.
Dialogue: 0,0:04:40.44,0:04:44.18,Default,,0000,0000,0000,,By mid-stage Alzheimer's,\Nwe have massive inflammation and tangles
Dialogue: 0,0:04:44.18,0:04:46.37,Default,,0000,0000,0000,,and all-out war at the synapse
Dialogue: 0,0:04:46.37,0:04:48.24,Default,,0000,0000,0000,,and cell death.
Dialogue: 0,0:04:48.24,0:04:51.35,Default,,0000,0000,0000,,So if you are a scientist\Ntrying to cure this disease,
Dialogue: 0,0:04:51.35,0:04:55.17,Default,,0000,0000,0000,,at what point would you ideally\Nwant to intervene?
Dialogue: 0,0:04:55.17,0:04:59.06,Default,,0000,0000,0000,,Many scientists are betting big\Non the simplest solution:
Dialogue: 0,0:04:59.06,0:05:02.85,Default,,0000,0000,0000,,keep amyloid plaques\Nfrom reaching that tipping point,
Dialogue: 0,0:05:02.85,0:05:06.28,Default,,0000,0000,0000,,which means that drug discovery\Nis largely focused on developing
Dialogue: 0,0:05:06.28,0:05:08.28,Default,,0000,0000,0000,,a compound that will prevent,
Dialogue: 0,0:05:08.28,0:05:13.02,Default,,0000,0000,0000,,eliminate, or reduce\Namyloid plaque accumulation.
Dialogue: 0,0:05:13.02,0:05:14.80,Default,,0000,0000,0000,,And so the cure for Alzheimer's
Dialogue: 0,0:05:14.80,0:05:18.07,Default,,0000,0000,0000,,will likely be a preventative medicine.
Dialogue: 0,0:05:18.07,0:05:21.45,Default,,0000,0000,0000,,We're going to have to take this pill\Nbefore we reach that tipping point,
Dialogue: 0,0:05:21.45,0:05:23.80,Default,,0000,0000,0000,,before the cascade is triggered,
Dialogue: 0,0:05:23.80,0:05:27.38,Default,,0000,0000,0000,,before we start leaving\Nour keys in the refrigerator.
Dialogue: 0,0:05:27.38,0:05:32.34,Default,,0000,0000,0000,,We think this is why, to date, these kinds\Nof drugs have failed in clinical trials,
Dialogue: 0,0:05:32.34,0:05:35.15,Default,,0000,0000,0000,,not because the science wasn't sound,
Dialogue: 0,0:05:35.15,0:05:36.76,Default,,0000,0000,0000,,but because the people in these trials
Dialogue: 0,0:05:36.76,0:05:39.19,Default,,0000,0000,0000,,were already symptomatic.
Dialogue: 0,0:05:39.19,0:05:40.72,Default,,0000,0000,0000,,It was too late.
Dialogue: 0,0:05:40.72,0:05:43.89,Default,,0000,0000,0000,,Think of amyloid plaques as a lit match.
Dialogue: 0,0:05:43.89,0:05:47.81,Default,,0000,0000,0000,,At the tipping point, the match\Nsets fire to the forest.
Dialogue: 0,0:05:47.81,0:05:49.86,Default,,0000,0000,0000,,Once the forest is ablaze,
Dialogue: 0,0:05:49.86,0:05:52.50,Default,,0000,0000,0000,,it doesn't do any good\Nto blow out the match.
Dialogue: 0,0:05:52.50,0:05:56.20,Default,,0000,0000,0000,,You have to blow out the match\Nbefore the forest catches fire.
Dialogue: 0,0:05:56.20,0:05:58.44,Default,,0000,0000,0000,,Even before scientists sort this out,
Dialogue: 0,0:05:58.44,0:06:01.49,Default,,0000,0000,0000,,this information is actually\Nreally good news for us,
Dialogue: 0,0:06:01.49,0:06:04.15,Default,,0000,0000,0000,,because it turns out that the way\Nwe live can influence
Dialogue: 0,0:06:04.15,0:06:06.43,Default,,0000,0000,0000,,the accumulation of amyloid plaques.
Dialogue: 0,0:06:06.43,0:06:08.03,Default,,0000,0000,0000,,And so there are things we can do
Dialogue: 0,0:06:08.03,0:06:10.69,Default,,0000,0000,0000,,to keep us from reaching\Nthat tipping point.
Dialogue: 0,0:06:10.69,0:06:13.28,Default,,0000,0000,0000,,Let's picture your risk of Alzheimer's
Dialogue: 0,0:06:13.28,0:06:15.27,Default,,0000,0000,0000,,as a see-saw scale.
Dialogue: 0,0:06:15.27,0:06:16.88,Default,,0000,0000,0000,,We're going to pile\Nrisk factors on one arm,
Dialogue: 0,0:06:16.88,0:06:19.36,Default,,0000,0000,0000,,and when that arm hits the floor,\Nyou are symptomatic
Dialogue: 0,0:06:19.36,0:06:22.06,Default,,0000,0000,0000,,and diagnosed with Alzheimer's.
Dialogue: 0,0:06:22.06,0:06:24.80,Default,,0000,0000,0000,,Let's imagine you're 50 years old.
Dialogue: 0,0:06:24.80,0:06:26.56,Default,,0000,0000,0000,,You're not a spring chicken anymore,
Dialogue: 0,0:06:26.56,0:06:29.58,Default,,0000,0000,0000,,so you've accumulated\Nsome amyloid plaques with age.
Dialogue: 0,0:06:29.58,0:06:32.06,Default,,0000,0000,0000,,You're scale is tipped a little bit.
Dialogue: 0,0:06:32.06,0:06:34.17,Default,,0000,0000,0000,,Now let's look at your DNA.
Dialogue: 0,0:06:34.17,0:06:38.11,Default,,0000,0000,0000,,We've all inherited our genes\Nfrom our moms and our dads.
Dialogue: 0,0:06:38.11,0:06:40.31,Default,,0000,0000,0000,,Some of these genes will increase our risk
Dialogue: 0,0:06:40.31,0:06:42.08,Default,,0000,0000,0000,,and some will decrease it.
Dialogue: 0,0:06:42.08,0:06:44.43,Default,,0000,0000,0000,,If you're like Alice in "Still Alice,"
Dialogue: 0,0:06:44.43,0:06:46.73,Default,,0000,0000,0000,,you've inherited a rare genetic mutation
Dialogue: 0,0:06:46.73,0:06:49.00,Default,,0000,0000,0000,,that cranks out amyloid beta,
Dialogue: 0,0:06:49.00,0:06:52.58,Default,,0000,0000,0000,,and this alone will tip\Nyour scale arm to the ground.
Dialogue: 0,0:06:52.58,0:06:56.43,Default,,0000,0000,0000,,But for most of us, the genes\Nwe inherit will only tip the arm a bit.
Dialogue: 0,0:06:56.43,0:06:59.04,Default,,0000,0000,0000,,For example, APOE4 is a gene variant
Dialogue: 0,0:06:59.04,0:07:01.27,Default,,0000,0000,0000,,that increases amyloid,
Dialogue: 0,0:07:01.27,0:07:04.90,Default,,0000,0000,0000,,but you can inherit a copy of APOE4\Nfrom mom and dad
Dialogue: 0,0:07:04.90,0:07:07.32,Default,,0000,0000,0000,,and still never get Alzheimer's,
Dialogue: 0,0:07:07.32,0:07:10.35,Default,,0000,0000,0000,,which means that for most of us,
Dialogue: 0,0:07:10.35,0:07:14.02,Default,,0000,0000,0000,,our DNA alone does not determine\Nwhether we get Alzheimer's.
Dialogue: 0,0:07:14.02,0:07:15.52,Default,,0000,0000,0000,,So what does?
Dialogue: 0,0:07:15.52,0:07:17.48,Default,,0000,0000,0000,,We can't do anything about getting older
Dialogue: 0,0:07:17.48,0:07:19.37,Default,,0000,0000,0000,,or the genes we've inherited.
Dialogue: 0,0:07:19.37,0:07:22.65,Default,,0000,0000,0000,,So far, we haven't changed\Nour brain's destiny.
Dialogue: 0,0:07:22.65,0:07:25.90,Default,,0000,0000,0000,,What about sleep?
Dialogue: 0,0:07:25.90,0:07:28.22,Default,,0000,0000,0000,,In slow-wave deep sleep,\Nour glial cells
Dialogue: 0,0:07:28.22,0:07:30.56,Default,,0000,0000,0000,,rinse cerebral spinal fluid\Nthroughout our brains
Dialogue: 0,0:07:30.56,0:07:34.22,Default,,0000,0000,0000,,clearing away metabolic waste\Nthat accumulated in our synapses
Dialogue: 0,0:07:34.22,0:07:36.25,Default,,0000,0000,0000,,while we were awake.
Dialogue: 0,0:07:36.25,0:07:40.03,Default,,0000,0000,0000,,Deep sleep is like\Na power cleanse for the brain.
Dialogue: 0,0:07:40.03,0:07:43.24,Default,,0000,0000,0000,,But what happens if you short-change\Nyourself on sleep?
Dialogue: 0,0:07:43.24,0:07:46.88,Default,,0000,0000,0000,,Many scientists believe\Nthat poor sleep hygiene
Dialogue: 0,0:07:46.88,0:07:49.80,Default,,0000,0000,0000,,might actually be\Na predictor of Alzheimer's.
Dialogue: 0,0:07:49.80,0:07:54.75,Default,,0000,0000,0000,,A single night of sleep deprivation\Nleads to an increase in amyloid beta.
Dialogue: 0,0:07:54.75,0:07:59.04,Default,,0000,0000,0000,,And amyloid accumulation\Nhas been shown to disrupt sleep,
Dialogue: 0,0:07:59.04,0:08:01.51,Default,,0000,0000,0000,,which in turn causes\Nmore amyloid to accumulate.
Dialogue: 0,0:08:01.51,0:08:04.00,Default,,0000,0000,0000,,And so now we have\Nthis positive feedback loop
Dialogue: 0,0:08:04.00,0:08:07.48,Default,,0000,0000,0000,,that's going to accelerate\Nthe tipping of that scale.
Dialogue: 0,0:08:07.48,0:08:09.72,Default,,0000,0000,0000,,What else?
Dialogue: 0,0:08:09.72,0:08:11.21,Default,,0000,0000,0000,,Cardiovascular health.
Dialogue: 0,0:08:11.21,0:08:14.84,Default,,0000,0000,0000,,High blood pressure, diabetes,\Nobesity, smoking, high cholesterol,
Dialogue: 0,0:08:14.84,0:08:18.83,Default,,0000,0000,0000,,have all been shown to increase\Nour risk of developing Alzheimer's.
Dialogue: 0,0:08:18.83,0:08:22.76,Default,,0000,0000,0000,,Some autopsy studies have shown\Nthat as many as 80 percent
Dialogue: 0,0:08:22.76,0:08:26.49,Default,,0000,0000,0000,,of people with Alzheimer's\Nalso had cardiovascular disease.
Dialogue: 0,0:08:26.49,0:08:29.45,Default,,0000,0000,0000,,Aerobic exercise has been shown\Nin many studies
Dialogue: 0,0:08:29.45,0:08:31.40,Default,,0000,0000,0000,,to decrease amyloid beta
Dialogue: 0,0:08:31.40,0:08:33.80,Default,,0000,0000,0000,,in animal models of the disease.
Dialogue: 0,0:08:33.80,0:08:37.57,Default,,0000,0000,0000,,So a heart-healthy Mediterranean\Nlifestyle and diet
Dialogue: 0,0:08:37.57,0:08:40.77,Default,,0000,0000,0000,,can help to counter\Nthe tipping of this scale.
Dialogue: 0,0:08:40.77,0:08:44.32,Default,,0000,0000,0000,,Okay, so there are many things\Nwe can do to prevent
Dialogue: 0,0:08:44.32,0:08:45.64,Default,,0000,0000,0000,,or delay the onset of Alzheimer's,
Dialogue: 0,0:08:45.64,0:08:48.03,Default,,0000,0000,0000,,but let's say you haven't\Ndone any of them.
Dialogue: 0,0:08:48.03,0:08:50.63,Default,,0000,0000,0000,,Let's say you're 65,
Dialogue: 0,0:08:50.63,0:08:54.22,Default,,0000,0000,0000,,there's Alzheimer's in your family,\Nso you've likely inherited a gene or two
Dialogue: 0,0:08:54.22,0:08:56.30,Default,,0000,0000,0000,,that tips your scale arm a bit,
Dialogue: 0,0:08:56.30,0:08:59.18,Default,,0000,0000,0000,,you've been burning the candle\Nat both ends for years,
Dialogue: 0,0:08:59.18,0:09:00.71,Default,,0000,0000,0000,,you love bacon,
Dialogue: 0,0:09:00.71,0:09:04.06,Default,,0000,0000,0000,,and you don't run unless\Nsomeone's chasing you.
Dialogue: 0,0:09:04.06,0:09:07.92,Default,,0000,0000,0000,,Let's imagine that your amyloid plaques\Nhave reached that tipping point.
Dialogue: 0,0:09:07.92,0:09:09.99,Default,,0000,0000,0000,,Your scale arm has crashed to the floor.
Dialogue: 0,0:09:09.99,0:09:11.70,Default,,0000,0000,0000,,You've tripped the cascade,
Dialogue: 0,0:09:11.70,0:09:13.28,Default,,0000,0000,0000,,setting fire to the forest,
Dialogue: 0,0:09:13.28,0:09:16.62,Default,,0000,0000,0000,,causing inflammation, tangles,\Nand cell death.
Dialogue: 0,0:09:16.62,0:09:19.82,Default,,0000,0000,0000,,You should be symptomatic for Alzheimer's.
Dialogue: 0,0:09:19.82,0:09:23.16,Default,,0000,0000,0000,,You should be having trouble\Nfinding words and keys
Dialogue: 0,0:09:23.16,0:09:26.92,Default,,0000,0000,0000,,and remember what I said\Nat the beginning of this talk.
Dialogue: 0,0:09:26.92,0:09:29.29,Default,,0000,0000,0000,,But you might not be.
Dialogue: 0,0:09:29.29,0:09:31.76,Default,,0000,0000,0000,,There's one more thing you can do\Nto protect yourself
Dialogue: 0,0:09:31.76,0:09:33.98,Default,,0000,0000,0000,,from experiencing\Nthe symptoms of Alzheimer's
Dialogue: 0,0:09:33.98,0:09:38.33,Default,,0000,0000,0000,,even if you have the full-blown disease\Npathology ablaze in your brain.
Dialogue: 0,0:09:38.33,0:09:42.98,Default,,0000,0000,0000,,It has to do with neural plasticity\Nand cognitive reserve.
Dialogue: 0,0:09:42.98,0:09:45.41,Default,,0000,0000,0000,,Remember, the experience\Nof having Alzheimer's
Dialogue: 0,0:09:45.41,0:09:49.34,Default,,0000,0000,0000,,is ultimately a result of losing synapses.
Dialogue: 0,0:09:49.34,0:09:52.84,Default,,0000,0000,0000,,The average brain has\Nover a hundred trillion synapses,
Dialogue: 0,0:09:52.84,0:09:55.32,Default,,0000,0000,0000,,which is fantastic. We've got\Na lot to work with.
Dialogue: 0,0:09:55.32,0:09:57.17,Default,,0000,0000,0000,,And this isn't a static number.
Dialogue: 0,0:09:57.17,0:10:00.51,Default,,0000,0000,0000,,We gain and lose synapses\Nall the time through a process
Dialogue: 0,0:10:00.51,0:10:02.22,Default,,0000,0000,0000,,called neural plasticity.
Dialogue: 0,0:10:02.22,0:10:04.52,Default,,0000,0000,0000,,Every time we learn something new,
Dialogue: 0,0:10:04.52,0:10:08.33,Default,,0000,0000,0000,,we are creating and strengthening\Nnew neural connections,
Dialogue: 0,0:10:08.33,0:10:10.100,Default,,0000,0000,0000,,new synapses.
Dialogue: 0,0:10:10.100,0:10:13.40,Default,,0000,0000,0000,,In the nun study,
Dialogue: 0,0:10:13.40,0:10:13.65,Default,,0000,0000,0000,,678 nuns,
Dialogue: 0,0:10:13.65,0:10:17.39,Default,,0000,0000,0000,,all over the age of 75\Nwhen the study began,
Dialogue: 0,0:10:17.39,0:10:19.92,Default,,0000,0000,0000,,were followed for more than two decades.
Dialogue: 0,0:10:19.92,0:10:23.32,Default,,0000,0000,0000,,They were regularly given\Nphysical checkups and cognitive tests
Dialogue: 0,0:10:23.32,0:10:27.05,Default,,0000,0000,0000,,and when they died, their brains\Nwere all donated for autopsy.
Dialogue: 0,0:10:27.05,0:10:31.79,Default,,0000,0000,0000,,In some of these brains, scientists\Ndiscovered something surprising.
Dialogue: 0,0:10:31.79,0:10:36.25,Default,,0000,0000,0000,,Despite the presence of plaques\Nand tangles and brain shrinkage,
Dialogue: 0,0:10:36.25,0:10:39.28,Default,,0000,0000,0000,,what appeared to be\Nunquestionable Alzheimer's,
Dialogue: 0,0:10:39.28,0:10:41.79,Default,,0000,0000,0000,,the nuns who had belonged to these brains
Dialogue: 0,0:10:41.79,0:10:46.29,Default,,0000,0000,0000,,showed no signs of having the disease\Nwhile they were alive.
Dialogue: 0,0:10:46.29,0:10:48.18,Default,,0000,0000,0000,,How can this be?
Dialogue: 0,0:10:48.18,0:10:51.97,Default,,0000,0000,0000,,We think it is because these nuns\Nhad a high level of cognitive reserve,
Dialogue: 0,0:10:51.97,0:10:56.11,Default,,0000,0000,0000,,which is a way of saying that they had\Nmore functional synapses.
Dialogue: 0,0:10:56.11,0:10:58.55,Default,,0000,0000,0000,,People who have more years\Nof formal education,
Dialogue: 0,0:10:58.55,0:11:00.96,Default,,0000,0000,0000,,who have a high degree of literacy,
Dialogue: 0,0:11:00.96,0:11:04.57,Default,,0000,0000,0000,,who engage regularly\Nin mentally stimulating activities,
Dialogue: 0,0:11:04.57,0:11:07.07,Default,,0000,0000,0000,,all have more cognitive reserve.
Dialogue: 0,0:11:07.07,0:11:11.11,Default,,0000,0000,0000,,They have an abundance\Nand a redundancy in neural connections.
Dialogue: 0,0:11:11.11,0:11:13.62,Default,,0000,0000,0000,,So even if they have a disease\Nlike Alzheimer's
Dialogue: 0,0:11:13.62,0:11:16.00,Default,,0000,0000,0000,,compromising some of their synapses,
Dialogue: 0,0:11:16.00,0:11:19.33,Default,,0000,0000,0000,,they've got many extra backup connections,
Dialogue: 0,0:11:19.33,0:11:23.04,Default,,0000,0000,0000,,and this buffers them from noticing\Nthat anything is amiss.
Dialogue: 0,0:11:23.04,0:11:25.43,Default,,0000,0000,0000,,Let's imagine a simplified example.
Dialogue: 0,0:11:25.43,0:11:28.18,Default,,0000,0000,0000,,Let's say you only know one thing\Nabout a subject.
Dialogue: 0,0:11:28.18,0:11:29.73,Default,,0000,0000,0000,,Let's say it's about me.
Dialogue: 0,0:11:29.73,0:11:32.06,Default,,0000,0000,0000,,You know that Lisa Genova\Nwrote "Still Alice,"
Dialogue: 0,0:11:32.06,0:11:34.60,Default,,0000,0000,0000,,and that's the only thing\Nyou know about me.
Dialogue: 0,0:11:34.60,0:11:36.92,Default,,0000,0000,0000,,You have that single neural connection,
Dialogue: 0,0:11:36.92,0:11:38.88,Default,,0000,0000,0000,,that one synapse.
Dialogue: 0,0:11:38.88,0:11:40.75,Default,,0000,0000,0000,,Now imagine you have Alzheimer's.
Dialogue: 0,0:11:40.75,0:11:43.44,Default,,0000,0000,0000,,You have plaques and tangles\Nand inflammation
Dialogue: 0,0:11:43.44,0:11:46.63,Default,,0000,0000,0000,,and microglia devouring that synapse.
Dialogue: 0,0:11:46.63,0:11:50.09,Default,,0000,0000,0000,,Now, when someone asks you,\N"Hey, who wrote 'Still Alice?'"
Dialogue: 0,0:11:50.09,0:11:55.33,Default,,0000,0000,0000,,you can't remember, because\Nthat synapse is either failing or gone.
Dialogue: 0,0:11:55.33,0:11:57.76,Default,,0000,0000,0000,,You've forgotten me forever.
Dialogue: 0,0:11:57.76,0:12:00.24,Default,,0000,0000,0000,,But what if you had learned more about me?
Dialogue: 0,0:12:00.24,0:12:02.53,Default,,0000,0000,0000,,Let's say you learned\Nfour things about me.
Dialogue: 0,0:12:02.53,0:12:05.29,Default,,0000,0000,0000,,Now imagine you have Alzheimer's,
Dialogue: 0,0:12:05.29,0:12:07.98,Default,,0000,0000,0000,,and three of those synapses\Nare damaged or destroyed.
Dialogue: 0,0:12:07.98,0:12:10.73,Default,,0000,0000,0000,,You still have a way\Nto detour the wreckage.
Dialogue: 0,0:12:10.73,0:12:13.39,Default,,0000,0000,0000,,You can still remember my name.
Dialogue: 0,0:12:13.39,0:12:17.23,Default,,0000,0000,0000,,So we can be resilient\Nto the presence of Alzheimer's pathology
Dialogue: 0,0:12:17.23,0:12:20.36,Default,,0000,0000,0000,,through the recruitment of\Nyet undamaged pathways,
Dialogue: 0,0:12:20.36,0:12:22.33,Default,,0000,0000,0000,,and we create these pathways,
Dialogue: 0,0:12:22.33,0:12:24.16,Default,,0000,0000,0000,,this cognitive reserve,
Dialogue: 0,0:12:24.16,0:12:26.71,Default,,0000,0000,0000,,by learning new things.
Dialogue: 0,0:12:26.71,0:12:31.00,Default,,0000,0000,0000,,Now ideally we want these new things\Nto be as rich in meaning as possible,
Dialogue: 0,0:12:31.00,0:12:35.76,Default,,0000,0000,0000,,recruiting sight and sound\Nand associations and emotion.
Dialogue: 0,0:12:35.76,0:12:39.38,Default,,0000,0000,0000,,So this really doesn't mean\Ndoing crossword puzzles.
Dialogue: 0,0:12:39.38,0:12:43.56,Default,,0000,0000,0000,,You don't want to simply retrieve\Ninformation you've already learned,
Dialogue: 0,0:12:43.56,0:12:47.04,Default,,0000,0000,0000,,because this is like traveling\Ndown old, familiar streets,
Dialogue: 0,0:12:47.04,0:12:49.70,Default,,0000,0000,0000,,cruising neighborhoods you already know.
Dialogue: 0,0:12:49.70,0:12:52.55,Default,,0000,0000,0000,,You want to pave new neural roads.
Dialogue: 0,0:12:52.55,0:12:55.11,Default,,0000,0000,0000,,Building an Alzheimer's-resistant brain
Dialogue: 0,0:12:55.11,0:12:57.31,Default,,0000,0000,0000,,means learning to speak Italian,
Dialogue: 0,0:12:57.31,0:12:59.24,Default,,0000,0000,0000,,meeting new friends,
Dialogue: 0,0:12:59.24,0:13:00.56,Default,,0000,0000,0000,,reading a book,
Dialogue: 0,0:13:00.56,0:13:03.39,Default,,0000,0000,0000,,or listening to a great TEDTalk.
Dialogue: 0,0:13:03.39,0:13:08.58,Default,,0000,0000,0000,,And if despite all of this, you are\Nsomeday diagnosed with Alzheimer's,
Dialogue: 0,0:13:08.58,0:13:11.35,Default,,0000,0000,0000,,there are three lessons I've learned\Nfrom my grandmother
Dialogue: 0,0:13:11.35,0:13:16.28,Default,,0000,0000,0000,,and the dozens of people I've come\Nto know living with this disease.
Dialogue: 0,0:13:16.28,0:13:19.12,Default,,0000,0000,0000,,Diagnosis doesn't mean\Nyou're dying tomorrow.
Dialogue: 0,0:13:19.12,0:13:20.87,Default,,0000,0000,0000,,Keep living.
Dialogue: 0,0:13:20.87,0:13:23.25,Default,,0000,0000,0000,,You won't lose your emotional memory.
Dialogue: 0,0:13:23.25,0:13:26.78,Default,,0000,0000,0000,,You'll still be able to understand\Nlove and joy.
Dialogue: 0,0:13:26.78,0:13:30.02,Default,,0000,0000,0000,,You might not remember what I said\Nfive minutes ago,
Dialogue: 0,0:13:30.02,0:13:32.67,Default,,0000,0000,0000,,but you'll remember\Nhow I made you feel.
Dialogue: 0,0:13:32.67,0:13:36.37,Default,,0000,0000,0000,,And you are more than what\Nyou can remember.
Dialogue: 0,0:13:36.37,0:13:37.84,Default,,0000,0000,0000,,Thank you.
Dialogue: 0,0:13:37.84,0:13:43.16,Default,,0000,0000,0000,,(Applause)