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Alzheimer’s disease is the most common cause of dementia in the world.
阿尔茨海默症是世界上最常见的痴呆症。
Nearly 50 million people worldwide have it, and every 66 seconds someone in the United States is diagnosed with it.
全世界有近5000万人罹患此病，且每66秒就有一个美国人被诊断为此病的患者。
It’s been called the epidemic of our century, but even after decades of research,
此病也被称为本世纪的流行病，然而，尽管已经研究了数十年，
finding a way to prevent this disease has been a puzzle that has eluded the medical community.
预防这种疾病的办法仍然是医学界的一大谜题。
Now, we may be closer than ever to solving it.
好在，现在我们或许比任何时候都要接近答案了。
"I personally have a lot of hope that we will see the first survivors of Alzheimer's disease in our lifetime.
“有生之年我们就能看到阿尔茨海默症的第一批幸存者，我个人对此是非常有信心的。
I’m Nilüfer Ertekin-Taner.
我叫Nilufer Ertekin-Taner。
I'm a neurologist and I'm a neuroscientist focused on Alzheimer's disease and related dementias."
我是一名神经科医师，也是一名专攻阿尔茨海默症及有关痴呆症的神经学家。”
Alzheimer's disease is a progressive condition, typically starting in the part of the brain associated with memory.
阿尔茨海默症是一种进行性疾病，通常，最先受到影响的是大脑中与记忆有关的区域。
It then spreads, causing trouble with memory, cognitive abilities and eventually, loss of bodily functions.
随后，病情会扩散，记忆、认知能力开始出现问题，最后便是身体功能的丧失了。
It's a relentlessly progressive condition that leads to death by or with the disease.
这种病的病情会不断地恶化，直到夺走病人的生命。
Age is the most common risk factor for Alzheimer's.
年龄是最容易引发阿尔茨海默症的因素。
In fact, about a third of individuals ages 85 or above have it.
事实上，85岁及以上的人群约有1/3的人都患有此病。
And while the exact onset of this disease is not known,
尽管这种疾病的确切发病时间还不确定，
what is known is that it is characterized by a buildup of toxic proteins in the brain.
我们知道的是，这种病的发作跟大脑中有毒蛋白质的积累有关。
"There are two main hallmarks of Alzheimer's disease in the brain.
阿尔茨海默症发作时，大脑中会出现两个主要特征。
One of them is amyloid beta, which builds up in plaques outside of neurons.
一个是神经元外斑块中的β淀粉样蛋白越来越多。
And the other one is tau, which is a fibrillar protein, which builds up inside of neurons.
另一个是神经元内的tau蛋白，一种纤维蛋白，也开始积聚。
Both of these proteins are toxic, and ultimately they lead to dysfunction and death of neurons."
这两种蛋白质都有毒，久而久之，神经元就会开始功能紊乱甚至死亡。”
As these proteins accumulate and neurons start to die, the brain’s immune system kicks into gear.
随着这两种蛋白质逐渐积累，神经元逐渐死亡，大脑的免疫系统开始启动了。
"The immune cells of the brain, called microglia, try to get rid of these toxic protein substances.
大脑里的免疫细胞，名为“小胶质细胞”，会试图清除这些有毒的蛋白质。
And they also try to get rid of the dead neurons."
同时试图清除那些已经死去的神经元。”
Ultimately, this immune response leads to chronic inflammation of the brain.
这样一来，这种免疫反应便会引发大脑的慢性炎症。
Over a longer period of time, as the disease progresses and neural cell death continues, the affected brain regions begin to shrink.
接下来，随着疾病的恶化和神经细胞的死亡，受影响的大脑区域会开始萎缩，这一过程持续的时间会更长。
And that’s about when symptoms start to show.
阿兹海默症的症状便是从这个时候开始显现出来的。
"Although it starts typically in areas that affect our memory,
“尽管这种疾病最先破坏的通常是大脑中与记忆有关的区域，
ultimately it starts affecting areas that control our movements, that control our swallowing and our breathing.
其最后开始破坏的是控制我们的行动，控制我们的吞咽和呼吸的区域。
And in the terminal stages of this condition,
这种病恶化到了晚期以后，
our patients with Alzheimer's disease lose their ability to move, and they become bedbound.
患者就会失去行动的能力，只能呆在床上了。
And at the end our patients unfortunately succumb to pneumonia, malnutrition, generalized sepsis of the body.
最终，他们会被肺炎、营养不良或是全身爆发的脓毒症带离人世。
And this is all because of Alzheimer's disease and what it does in the brain."
这一切都是因为阿尔茨海默氏症以及这种疾病对大脑造成的破坏。”
And while this all sounds dire, decades of studies on patients show that
虽然听上去很恐怖，好在数十年的临床研究已经表明，
there may be a window of opportunity to prevent the condition advancing before you would see any symptoms.
或许，我们还有机会在症状出现之前阻止病情的进一步恶化。
"We know that 10 or 20 years before the symptoms of Alzheimer's disease can be observed, there are changes in the brain.
“我们知道，阿尔茨海默症症状还没爆发的10~20年时间里，大脑内部就已经开始发生变化了。
We know this from biomarker studies looking at levels of abnormal proteins in the spinal fluid, in the brain, or in blood.
这一结论是我们研究生物标记，观察脊髓液、大脑或血液中异常蛋白的水平的结果。
So biomarkers are quantifiable measures that can help us detect disease or an aspect of the disease.
而生物标记是能够帮助我们检测疾病或疾病的某个特征的可量化指标。
So for example, we can think blood glucose levels as being a biomarker for diabetes.
打个比方，我们可以将血糖水平视为糖尿病的一个生物标记。
We can think about blood pressure measurements as being a biomarker for high blood pressure.
把血压测量结果视为高血压的一个生物指标。
In the same vein, we have developed, and continue to develop biomarkers for Alzheimer's disease."
我们用类似的方法确定了并在持续确定阿尔茨海默症的生物标记。”
And while these biomarkers are important to follow the disease’s progression the research is still ongoing.
尽管这些生物标记对跟踪疾病的进展颇为重要，医学界的研究却并未因此止步。
Right now, knowing a patient's risk factors can help them make choices to slow the onset of Alzheimer’s.
了解可能诱发阿尔兹海默症的风险因素能帮助患者决定何时开始延缓阿尔茨海默症的发作。
"Those risk factors that are bad for your heart are generally bad for your brain.
“有害心脏健康的风险因素通常也有害于大脑的健康。
So diabetes, hypertension, smoking and obesity are risk factors for Alzheimer's disease.
所以，糖尿病、高血压、吸烟和肥胖都是阿尔茨海默症的风险因素。
On the flip side, What we recommend to our patients, and even the general public
另一方面，我们推荐我们的病人——普通大众也不例外——
is that they stay engaged, both cognitively, physically and socially."
保持参与，而且，无论是认知方面，身体方面还是社交方面都要保持参与。
That can be anything from exercise to maintaining a strong social network.
无论通过哪种方式，无论是锻炼也好，维持广泛的社交圈子也好。
The takeaway seems to be: stay active.
总结起来差不多就是：保持活跃。
"We are also at an amazing time in research and clinical studies.
“在研究和临床研究方面我们也正处于一个成果惊人的时期。
We are able to combine clinical information with very complex genetic and other molecular information.
我们已经能将临床信息与非常复杂的遗传等分子信息结合起来研究了。
And this helps us try and identify the very complex molecular perturbations that can lead to this condition."
有了这一技术，我们就能识别分子层面引发这种疾病的分子扰动情况了。”
