At the beginning of the video, Genova discussed how people fear AD because there is no disease-modifying treatment or cure. Then, she began to discuss the disease development. The synapse is where two neurons connect, neurotransmitters are released, signals are transmitted, and communication happens. I learned that AD takes place in the synapse. Furthermore, I learned that neurons not only release neurotransmitters in the synapses, but they also release a small peptide called amyloid beta. Microglia, the brain’s janitor cells, metabolize the amyloid beta. Many neuroscientists believe that AD begins when amyloid beta accumulates in the synapses, causing a binding mechanism. The binding in the synapse forms sticky aggregates called amyloid plaques. Next, I thought that it was interesting to learn that people around the age of forty may not show any impairments in memory, language, or cognition. In this case, PET scans are used to detect amyloid plaques. Then, I learned that it takes at least 15 to 20 years of amyloid plaque accumulation before it reaches a tipping point. Prior to the tipping point, people may notice lapses in memory.
I thought that it was helpful that Genova gave examples of questions that would be associated with memory lapses. In one example, she stated, “Where did I put my keys?” The example of forgetting the location of the keys may happen to someone who was not paying attention. The important point to this disease is understanding that after the tipping point, glitches in memory are very different. Instead of someone finding the keys in a coat pocket, the keys are in the refrigerator. Likewise, another sign of AD would be finding the keys and thinking, “What are these for?” When amyloid plaques accumulate to the tipping point, the microglia janitor cells become hyper-activated. They release chemicals that cause inflammation and cellular damage. Then, the transport protein, tau, becomes twisted and tangled. This twisting chokes off the neurons from the inside. Someone who has mid-stage AD, has massive inflammation, tangles, and cell death.
Genova stated that the cure for AD will likely be a preventative medicine to reduce the accumulations of the plaque. However, the pill would have to be taken before reaching the tipping point. I learned that the probable reason that past clinical trials have not been successful in finding a cure is because the people in the clinical trials were already symptomatic. Also, I learned that DNA alone does not determine if people get AD. Many scientists believe that poor sleep hygiene, might be a predictor of AD. It was surprising to learn that a single night of sleep deprivation leads to an increase in amyloid beta. Amyloid accumulation has been shown to disrupt sleep, which causes more amyloid to accumulate. Thus, this process causes a positive feedback loop that accelerates the tipping scale. Other factors leading to AD are poor cardiovascular health, high blood pressure, diabetes, obesity, smoking, and high cholesterol. Likewise, some autopsy studies have shown that 80% of people with AD also had cardiovascular disease.
Aerobic exercise has been shown to decrease amyloid beta. Another important factor in decreasing the likelihood of AD is neuroplasticity and cognitive reserve. Hence, someone with more years of formal education, a high degree of literacy who engages regularly in mentally stimulating activities, would have more functional synapses. AD is the result of losing synapses. Through neuroplasticity, people gain and lose synapses all the time. With cognitive reserve, one will have backup connections even with the presence of AD. Cognitive reserve is built by learning new things, such as, learning to speak a different language, making new friends, or watching a TED talk.
To further my learning, I explored cognitive reserve research studies and other preventable measures against AD. I chose this TED talk as part of my assignment because Genova thoroughly described the disease development, while using research to back up her statements. Additionally, I chose this video because this video provided information on AD risk factors and proactive preventative measures against the disease. After watching this video, I learned that people with AD do not lose their emotional memory and that they can still understand love. It really stood out to me that Genova said, “Alzheimer’s disease does not mean you’re dying tomorrow; keep living.” I think that this is very important to understand. Each day is a gift, and one has the choice to make a positive difference in the world or to stop trying. In relation to occupational therapy, clients may not remember what was said, but they will remember how the therapist made them feel. As a future occupational therapist, I will encourage my clients to reach their full potential and to always keep trying.
I recommend this video to anyone who would like to learn more about Alzheimer’s disease and ways to prevent it.
Genova, L. (2017, April). What you can do to prevent alzheimer’s [Video]. TED Conferences. https://www.ted.com/talks/lisa_genova_what_you_can_do_to_prevent_alzheimer_s?language=en
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