It's like the end of the world to me

對我來說這就是世界末日阿！

I'm so sorry to hear that

我很抱歉聽到這個消息 你還好嗎？

Are you feeling better ?

恩我有好一點了

Yeah I'm getting better but I'm just so forgetful now

但我變得有點容易健忘耶！為什麼？

Why?

大家好，歡迎收看美醫學英文

Hi everyone welcome to MEnglish

讓我們一起變美吧！

Well First things first subscribe

恩第一件事最重要的就是訂閱我們啦

Because you do care about health and beauty right

因為各位都很在乎健康與美麗對吧？

So simply subscribe subscribe subscribe

那就動動你的手指訂閱訂閱再訂閱啦

And all this presented to you by MEmedia

所有的優質內容都由美醫誌為您呈現喔

Do you easily forget things ?

你是不是容易忘記事情

like walked into the kitchen

就像走進廚房裡面卻不知道要找什麼

but forgot what you were looking for

這就要當心了

This could be neurocognitive disorder or dementia

這可能會是神經認知障礙或是失智症的前兆

and even at such a young age it's still very possible

即使是在年輕的族群也是有可能的

But don't be afraid we'll be speaking to Dr. Wu today

但各位不要太擔心今天我們請來了吳醫師來幫助我們

who's here to help us

讓我們歡迎吳醫師

Let's welcome Dr. Wu

大家好我是我是Ana吳醫師

Hello everyone I'm Dr. Ana Wu

很開心今天跟大家在這裡見面

It's such a pleasure to be here

吳醫師我聽說有些人似乎是容易健忘

Dr. Wu I've heard that some people are just more forgetful

但有可能在年輕的時候得到失智症或是神經認知障礙嗎？

but is it possible to be getting dementia or the

這的確是有可能的

neurocognitive disorder at such a young age ?

即使這個機率很低但的確有這個可能性存在

It is possible even though the risk is lower

各位聽到了嗎？我想我們有必要了解更多

but it is definitely a possibility

你在找什麼呢？

Wow you heard that

我在找我的手機啦吳醫師，你有看到它嗎？

I think we need to find out more

我看看喔…..喔它在這裡啦

What are you looking for ?

真是謝謝你耶，我找了它一整天了

I'm looking for my phone Ana did you see it ?

發生什麼事了嗎？

Let's see oh wait I think it's over here

噢告訴你一個秘密我上個月跟我男朋友分手了

Thank you

而且自從那之後我就心不在焉的

I've been looking for it all day

我不能專心 我不能工作 我不能動了！

What's going on ?

對我來說這就是世界末日阿！

Well tell your a secret actually I broke up with my boyfriend last month

我很抱歉聽到這個消息 你還好嗎？

and since then I've been so absent-minded

恩我有好一點了

I can't focus I can't work I can't function

但我變得有點容易健忘耶！為什麼？

It's like the end of the world to me

有時候你處在一個極端的壓力之下

I'm so sorry to hear that

你會經歷很多事情

Are you feeling better ?

尤其是大腦會思考很多事情

Yeah I'm getting better but I'm just so forgetful now

但通常來說這是暫時的而且會隨著時間過去

Why ?

恩我真是鬆了一口氣呢！

Well sometimes when you're very stressed

我甚至還請AMY醫師陪我去醫院掛號

or you're going through a lot you can

你不用太擔心啦

You can interfere with how your brain functions

其實健忘跟神經認知障礙或是失智症是不太一樣的喔

But that's usually temporary and it goes away with time

吳醫師我有看到很多年輕人案例是關於失智症的

What a relief to hear that !

你可以簡短介紹一下什麼是失智症和神經認知障礙嗎？

You know I was so worried I even asked Dr. Amy

好的失智症是一種由多數症狀引起的病症

to please go to the hospital with me later for a checkup

它會干擾人們的思想、記憶

You don't have to worry too much

以及人如何看待個世界與人們溝通的情形

Being forgetful and having dementia or neurocognitive disorder is quite different

不單單只是健忘這麼簡單，它是很複雜的

Hi Dr. Wu we do see a number of cases

那如果有人得到了失智症我們怎麼去分辨它

where young people are getting dementia

這是個好問題

Can you briefly explain what is dementia

基本上我們診斷出一個人有失智症

or the neurocognitive disorder ?

表示我們看到那個人在行為認知上有明顯的下降

Sure so dementia is a collection of symptoms

尤其是在行動前後的對比

that can be caused by a variety of different diseases

這種認知上的損害至少是有六大項

and so it interferes with how people think

每一項都有點不太一樣

how people remember how people see the world and

第一項要素是語言和記憶

how people communicate

這也是關於失智症發生最多的一環

So it's not just being about being forgetful

每個人都有數不清記不起來的事

It's a lot more than that

所以每個人記憶的變化在開始是非常微妙的

Wow so how can we tell if a person has this ?

失智症患者例如他們可能會忘記電話號碼

That's a very good question

會忘記今天發生的一些事件

So basically we diagnose a person with dementia

甚至會忘記早餐吃了什麼

when we see that there's a

這些都是在短期記憶中會出現的

significant cognitive decline in the same person

但他們會記得他們小學時代喜歡的人

compared to how they were functioning before

還有人會記得他們是怎麼去學校的

And this impairment has to be in at least

就長期記憶來說是被保存的

one of six cognitive domains

這就是第一項要素

and these domains are very different

第二項是語言能力的喪失

So the first one is language and memory

有些人對於了解其他人開始變得困難

which is the most relatable one

還有些人與外在溝通上出現了問題

Everyone has bouts of forgetting things

這就是語言能力受損，類似雙向溝通的事

so their memory changes can be very subtle in the beginning

這聽起來真的很複雜

For example they might forget phone numbers

那麼狀況惡化了會怎麼樣？

or they might forget events that happened during the day

對我們提到了對於認知領域兩項要素的變化

or just things they had for breakfast

第三個就是執行功能上的不完整

So really a prominent in recent memory

就像是我們大腦會想計畫一天的行程並安排妥當

But they will remember for example

但是失智症病人可能沒辦法做到這點

who was their elementary school sweetheart

執行旅遊計劃都有困難

and they will remember um where they went to school

或是維持個薪資本都顯得困難

like long-term memory is preserved

這也是其中之一

So that's the first cognitive domain that's affected

第四點是整體的注意力會不集中

But also language can become impaired

注意力不集中大家就比較知道

So some people have trouble understanding people

失智症患者很容易被外在事物分心

and some other people have some patients

在工作上也沒辦法多工或一心多用

have trouble communicating

第五點是知覺動作的退化

what they're thinking to the outside world

舉例來說你看到一把梳子

So it's like a bidirectional thing

你卻不知道它是用來做什麼的

in terms of language

你知道它看起來似曾相識但是你並不會用它來梳頭髮

Wow this is quite complicated

基本上就是你看到但卻不知道

So what are the worsening signs ?

這就是知覺動作的退化

Right so we mentioned two changes in cognitive domains

最後一點是社交認知的混亂

and the third one is called executive functioning

身為成年人我們都知道什麼該做什麼不該做

So that's like a set of mental skills

有點類似察言觀色的感覺

that allows us to plan our day and stay organized

但失智症患者或神經認知障礙患者可能沒有這層顧慮

So for example patients might start having trouble

他們會變得異常的誠實，或是誠實過了頭

planning what to do throughout the day

或是做一些一般大眾不被接受的事情

or they might have trouble planning a trip

以上六點只要有一點發生在身上

or just even maintaining like a paycheck book

就會診斷的出來失智症或是神經認知障礙

That's one of them

那哪個年齡層是最容易得到呢？

And then the fourth one is complex attention

因為我們都叫這個阿茲海默症

So complex attention means that patients

而且年輕的案例也是所在不有

are having trouble concentrating

這是一個好問題

They become easily distracted and

我們通常會把神經認知障礙與年紀

they might not be able to multitask

有一點點長的人聯繫在一起

And the fifth dimension that's affected

通常是65歲以上的長者

it's called perceptual-motor

不過也有可能發生在45歲左右的人

So what that means is that for example

假如你在45歲前有被診斷出失智症或是神經認知障礙

you see a hairbrush

我們叫做早發期失智症

and you don't know what is it for

大約30歲左右？這也太年輕了吧

You know that it's something that looks familiar

這樣的年輕人生才剛開始

but you don't know to pick it up and brush your hair

有些人也剛結婚生小孩啊！

So basically means you don't know what you see

有任何預防措施嗎？還是有任何的療法？

That's what a perceptual-motor means

這也是一個好問題

And the sixth domain that's affected

有很多的治療方式像是藥品或另類藥物治療

it's called social cognition

不過這些方式只是延緩症狀

So as grown-ups we know what's socially acceptable

不能說是真正的治癒

and what's not

以我的觀點來看最好的方法是事前去預防

But this filter kind of becomes a little permeable

預防方式是有幾點可以去做的

when you have dementia or

要做到的就是過著健康的生活

neurocognitive disorder

舉例來說先從健康飲食開始

So the patients become very honest brutally honest

每個醫師都這麼說對吧？健康飲食

or they start doing things that are not so socially acceptable

健康飲食之所以重要是因為

And out of the six domains you just need one of them

如果你吃了太多的甜食或炸物

at least one impairment in one area

或是有些食物吃了會讓你身體發炎

and that's how dementia or

呈現發炎的前兆這就會引起很多的問題

neurocognitive disorder is diagnosed

慢性病就會找上你了

So which age group is the most vulnerable ?

比如像是高血壓、血糖過高

Because we call this the alzheimer's disease

糖尿病以及心臟問題等等

but we do see cases of young people

這些慢性病都有可能引發失智症或是神經認知障礙

That's a very good question

所以健康飲食中包含大量的綠色蔬菜是非常重要的

So usually we associate neurocognitive disorder

第二個重點就是要運動

with patients who are a little bit older

運動一方面可以幫助你減壓

So usually it's above the age of 65 years old

壓力對人們來說是不好的

But so there's cutoff and that's somewhat

而且壓力會導致身體發炎更多

arbitrary at the age of 45

所以要盡可能地去紓解壓力

So if you're diagnosed with dementia

而運動就是一個好方法

or neurocognitive disorder before the age of 45

另外運動可以讓你的血液循環變的更好

then we call that early onset dementia

那是很重要的因為如果血液循環順暢

Like 30 something years old

就可以排出身體的毒素

That's so young I mean we are just starting

也可以排出那些有可能造成失智症的物質

a new chapter in our life

第三點就是要睡個好覺

People are just getting married or having kids

這也是超級重要的

Are there any preventions or how about treatments ?

每天我們的大腦都會分泌一種蛋白質

That's a really good question too

我們叫做類澱粉斑塊

So there are many treatment options available

當類澱粉斑塊製造過多時阻礙我們大腦

in terms of drugs and pharmacotherapy

就會造成失智症或是神經認知障礙

But what these drugs do is they slow the progression

雖然每個人身體製造出此類的蛋白質

of the disease without really curing it

但大腦是非常聰明的

or terminating it

大腦有一種機制是膠狀淋巴系統

So in my opinion the best way to approach

它可以清除此類的蛋白質

or tackle this problem is to prevent it

而且它只在睡覺的時候出現

And in terms of prevention there are

如果你睡的不夠多也睡得不夠好

a number of things that you can do

這就會促進失智症的產生

And they all have to do with like a healthy lifestyle

第四點呢我認為是重點也是非常必要的

For example first you can eat a healthy diet

就是保持開放接納的心態

Every doctor says that right

願意讓自己學習更多的新事物

Healthy diet

並且保持自己的彈性和靈活

But that's very important because if you're

大腦就會認為有受到刺激

eating a lot of sugary foods or fried foods

但如果你很頑固而且都做同樣的事

or just foods that promote inflammation in the body

不學習新的東西的話

What it does is that your body goes into a

大腦認為你很無聊

pro-inflammatory state

你就有可能會促進失智症和神經認知障礙的症狀了

And that causes a lot of problems

挖聽起來健康飲食和規律運動是非常必須的

because it gives you chronic medical conditions

你知道嗎我可是有常常讓我的大腦在活動呢

like hypertension like blood sugar problems

我每天都看很多臉書的資訊

diabetes or heart problems

哇這是一種方式啦

And all of that can contribute to the development

不過你要不要試試看讀一本真正的書

of dementia or neurocognitive disorder

少用臉書也比較好啦

So eating healthy lots of green vegetables and

這本書也可以刺激你的大腦阿

just leafy greens that's very important

謝謝吳醫師讓我就從今天開始讀囉

The second thing that's very important is exercise

不客氣

Yeah because exercise on the one hand

失智症

can help you de-stress

失智症

and stress is bad for you because again

神經認知障礙

it contributes to adding inflammation

神經認知障礙

and oxidative stress in our body

執行功能

So you want to de-stress any way possible

執行功能

exercise is a really good option

記憶

And the second part is that exercise also keeps

記憶

your blood vessels your circulatory system

情緒

very healthy

情緒

That's very important because if you have

社交認知

like a good circulatory system

社交認知

you can get rid of the toxins

壓力

that build up in your brain and that cause dementia

壓力

And the third thing that you can do is

像金魚一般的記憶

you can get a good night's rest

像金魚一般的記憶

That's super important as well

這表示人們很容易忘記事情

So what happens is that every day

很高興今天能邀請吳醫師來

we're building up lots of protein in our brain

也很謝謝她

and we call that amyloid plaques

你有上述說的症狀嗎？

And when that builds up a lot

希望你沒有

you get dementia or neurocognitive disorder

如果你真的忘記了記得要再看一遍喔

So everybody builds up this protein

我們下回見囉 掰掰!

but the brain is very smart

and we have the system called the

glymphatic system

and it clears up this protein buildup

and it only does it during sleep

So if you're not getting enough hours of sleep

or you're not sleeping well

hen you're more prone to developing dementia

And the fourth one which I think is vital

and imperative is being open-minded

and willing to put yourself to learn more things

and being very flexible

So then the brain considers that

something very intellectually stimulating

But if you're very stubborn

and you're always doing the same things

you never learn things

Then the brain finds a very boring

and then it's easier for you to develop

symptoms of dementia or neurocognitive disorder

Wow sounds like a healthy eating

regular exercise is really necessary

Yeah you know I actually keep my brain really active

I read a lot of facebook

Oh well that's one way to go over here

How about you try this book and you

use a little bit less of a facebook

This can be very intellectually stimulating

for your brain

Thank you Ana let me start with this today

You're very welcome

dementia

dementia

neurocognitive disorder

neurocognitive disorder

executive functioning

executive functioning

memory

memory

emotions

emotions

social cognition

social cognition

stress

stress

To have a memory of a goldfish

This is an expression that refers to

people who are often forgetful

Well it's a great pleasure having Dr. Wu today

and thanks to her

Do you have one of these domains ?

Does that apply to you ?

Hopefully not

And if you have forgotten watch again

See you next time bye-bye