Name: 什麼是失智症的元兇？跟著腦科專家一起解析阿茲海默症與腦部受損真相（THIS Is The Fastest Way To Get Dementia… | The Brain Doctor, Dr Ann Mckee）
Uploaded: 2026-03-10T07:25:30.000Z
Duration: 8 min 30 s

You mentioned that you've looked at lots of brains of people that have Alzheimer's.

你提到你看了很多罹患阿茲海默症的腦部。

Bit of a dumb question, but what is the difference between Alzheimer's and dementia?

雖然是個笨問題，但阿茲海默症和失智症有什麼不一樣？

Yeah, it's a great question because everybody is confused.

耶，這是個好問題，因為大家都很困惑。

So dementia is sort of this general term.

所以失智症其實是一個比較籠統的說法。

It's dementia, which means the loss of your mental abilities, you know, dementating.

就是失智症，意思就是你的認知能力退化，你知道的，就是失智。

So loss of cognitive abilities, dementia.

There are many subcategories of dementia.

The most common cause of dementia is Alzheimer's disease.

失智症最常見的病因就是阿茲海默症。

It's the most common age related cause of dementia.

這是最常見的與年齡相關的失智症病因。

But then under Alzheimer's there's also Parkinson's disease.

但阿茲海默症底下還有帕金森氏症。

With Lewy body disease, there's something called frontotemporal lobar degeneration.

路易氏體失智症，還有一個叫做額顳葉退化症。

Then there's, you know, you get into odder and rarer diseases.

然後還有，你知道的，一些比較奇怪比較少見的疾病。

Progressive supral nuclear palsy, Gaumanian dementia.

進化性核上麻痺，關曼氏失智症。

所以 CT。 CTE 是失智症的病因。

那我怎麼避免得到阿茲海默症呢？

Well, you know, it's a very common disease.

嗯，你知道的，這是一種很常見的疾病。

It's supposedly in over 50% of people that live to the age of 85.

據說，活到 85 歲的人，有超過一半的人會有。

If you looked at their brains, half of them would have Alzheimer's disease.

如果你看他們的腦部，其中一半會有阿茲海默症。

Not everyone gets the symptoms of Alzheimer's disease at 85, but they'd have the pathology.

並不是所有人在 85 歲都會出現阿茲海默症的症狀，但他們會有病理變化。

Now, things you can do to lessen the symptoms of Alzheimer's disease are staying socially connected, using your brain, challenging your brain.

現在，你可以做些什麼來減輕阿茲海默症的症狀呢？就是保持社交連結，動動腦，挑戰你的大腦。

Because high cognitive reserve, high cognitive ability gives you strength, brain strength, brain resilience against these diseases.

因為高認知儲備、高認知能力能讓你對抗這些疾病，擁有大腦強度、大腦韌性。

So even if you have pathology, you can circumvent the areas of injury, the areas that aren't working well, and

所以即使你有病理變化，你也能繞過受損區域，繞過那些運作不好的地方，

So that's one thing, you know, physical activity, fitness, but

所以這是一件事，你知道的，就是身體活動、健身，但

also mental fitness, challenging your brain, keeping it active, developing a high cognitive reserve.

還有心智鍛鍊，挑戰你的大腦，讓它保持活躍，發展高認知儲備。

And then the other things you can do is, you know, stay fit, eat right.

然後你可以做的其他事情是，你知道的，保持健康、飲食均衡。

Cardiovascular health is intimately connected to Alzheimer's disease.

You want to avoid high blood sugar diabetes because that can definitely hasten Alzheimer's disease.

So it's really a story of staying healthy.

Alcohol, well, alcohol can damage your brain and alcohol damages it in entirely different ways than Alzheimer's or cte.

But if you do drink alcohol, it can exacerbate your symptoms, it can make your symptoms worse.

And we don't have any direct connection between alcohol and Alzheimer's, but, you know, we do know that it's not good for your brain health.

心血管健康與阿茲海默症息息相關。

It damages parts of the brain that can lead to cognitive problems.

你想要避免高血糖糖尿病，因為那肯定會加速阿茲海默症的發生。

所以這真的很像一個保持健康的故事。

No, I Think our awareness of these diseases is increasing.

酒精，嗯，酒精會損害你的大腦，而且酒精損害大腦的方式與阿茲海默症或 CTE 完全不同。

You know how we used to call it senile dementia?

但如果你確實飲酒，它會加劇你的症狀，會讓你的症狀更嚴重。

So, you know, we sort of dismissed it as just old age.

所以你知道，我們就把它當成是單純的老化。

But there are some people that live to very old ages that are perfectly intact.

但有些人活到很老，卻依然頭好壯壯。

So these are abnormal aging, these are pathological aging.

所以這些是異常老化，是病理性的老化。

And we're much more aware of it than we were, say, 40 years ago.

我們現在對這件事的意識比 40 年前高多了。

Forty years ago, we really had no concept how common this disease was.

40 年前，我們根本不知道這種病有多普遍。

Is there anything that you believe about the brain that most people disagree with?

你有沒有什麼關於大腦的看法，是大多數人都不同意的？

So, as it relates to Alzheimer's and cte, is there any sort of fundamental beliefs that you're currently trying to prove out through your testing and the things you're doing at Boston University?

所以，就跟阿茲海默症和 CTE 有關，你目前有沒有什麼基本信念，正透過你的測試和在波士頓大學做的事情來驗證？

I don't know if other people don't believe them, But

我不知道別人是不是不相信，但

I do feel that inflammation, anything that causes inflammation in your brain, and

我覺得發炎，任何會讓你的大腦發炎的東西，還有

I think what a lot of people would agree with me, inflammation is one of the key promoters of brain disease and neurodegeneration.

我認為很多人會同意我，發炎是腦部疾病和神經退化的關鍵推手之一。

So there's tremendous inflammation in Alzheimer's disease, tremendous inflammation in cte, and

所以阿茲海默症和 CTE 都有嚴重的發炎，

if we could figure out sort of this bad inflammation, we might be able to prevent or at least stave off these terrible diseases.

如果我們能找出這種不良發炎的根源，也許就能預防，或至少延緩這些可怕的疾病。

And the other thing that I think is very important is small vessel disease, vascular disease, the health of these small blood vessels that are so important in terms of giving, oxygenating our brain, if they become damaged or injured through a variety of mechanisms, then we also see these diseases being accelerated.

另一件我認為非常重要的事是小血管疾病，血管疾病，這些對我們大腦供氧非常重要的小血管的健康，如果它們因為各種機制受損或受傷，我們也會看到這些疾病加速惡化。

So, you know, I think there needs to be a lot more attention to the earliest changes that are associated with these diseases.

所以，我認為需要更多關注與這些疾病相關的最早期變化。

And in my mind, those are vascular changes and inflammation.

在我心中，那些就是血管變化和發炎。

And what kinds of things cause inflammation in the brain?

Really, any insult to the brain, Certainly, if the blood vessels are damaged and they become leaky, you get substances leaking into the brain that irritate the brain and cause tremendous, tremendous inflammation.

其實，任何對大腦的傷害，特別是當血管受損變得滲漏時，會有物質滲入大腦刺激它，造成非常嚴重的發炎。

The blood brain barrier is a very tight barrier.

血腦屏障是一個非常緊密的屏障。

You can have all sorts of toxins in your blood, but

你的血液裡可能有很多毒素，但是

they're not getting into your brain because you have such a tight barrier between the blood and the brain.

因為血液和大腦之間有這麼緊密的屏障，它們進不去你的大腦。

We keep out all sorts of noxious substances, but if you injure the blood vessels, they leak.

我們擋住了各種有害物質，但如果血管受傷，它們就會滲漏。

And all those things that we are trying to keep out of our brain leak into the brain and promote inflammation.

而所有我們試圖擋在大腦外面的東西，都會滲入大腦並引發發炎。

Those changes can facilitate neurodegeneration.

And the things that make those blood vessels become injured, well, trauma, trauma that back and forth.

而導致血管受傷的因素，像是創傷，來來回回的創傷。

But also things that affect vascular health, like High blood pressure, high cholesterol, blood sugar.

但也包括影響血管健康的東西，像是高血壓、高膽固醇、血糖。

Stress, you want to reduce stress, you want to stay physically fit, you want to eat.

壓力，你要減輕壓力，要保持身體健康，要飲食。

It's just the things that sleep, you know, sleep is so important for because at the end of the day, your sleep, you're actually clearing bad substances out of your brain.

只是睡眠這件事，你知道，睡眠非常重要，因為歸根究柢，睡眠時，你其實是在清除大腦中的有害物質。

You have a clearance system in your brain that is most active when you sleep.

你大腦有個清除系統，在睡眠時最活躍。

And so when you're sleeping, it's pulling out the noxious chemicals, it's draining them into your, into your system so you can get rid of them.

所以當你睡覺時，它會將有害化學物質排出，排入你的系統，這樣你才能擺脫它們。

We probably have a few million parents listening at the moment to this conversation and, and

現在可能有一兩百萬的父母正在聽我們哈拉，

those parents, you know, their kids are saying, I want to play rugby, I want to play soccer, I want to play American football, I want to do hockey.

那些父母，你知道，他們的小孩會說，我想打橄欖球、我想踢足球、我想打美式足球、我想打冰球。

Well, you know, every parent is different.

嗯，你知道，每個父母都不一樣。

You have to really understand your child.

Is it that they need to play that particular sport or could they be as.

是他們需要玩那個特定的運動，還是他們也可以。

Just as easily, could they be just as happy in a non contact sport?

也很容易，他們也可以在非接觸性運動中獲得快樂？

They're playing plenty of non contact sport.

他們可以玩很多非接觸性的運動。

There are plenty of sports that have low risk, so I would promote all of those.

有很多低風險的運動，我會大力推薦。

And then if they're playing, they choose.

然後如果他們在玩，是他們自己選擇。

If they think, you know, this is a decision that they want to make despite the risks, then, you know, make sure the coach is very, very well, you know, versed in some of the adverse consequences of concussions.

如果他們覺得，你知道，這是他們想做的決定，儘管有風險，那麼，你知道，要確保教練非常、非常瞭解，你知道，腦震盪的一些不良後果。

And those hits to the head, even the non concussive hits, make sure that there's good education, good education of the player as well as the teammates, as well as the coach.

還有那些頭部撞擊，即使是沒有造成腦震盪的撞擊，要確保有良好的教育，對球員、隊友和教練都有良好的教育。

And then, you know, try to delay playing full contact as long as possible.

然後，你知道，盡量延後玩全身接觸的運動。

I think you should delay it until the person's physically robust has, with a musculature with a strong neck, they're able to, you know, resist hits.

我認為你應該延後，直到這個人身體強壯，有肌肉，有強壯的頸部，他們能夠，你知道，抵抗撞擊。

There's, you know, a blindsided hit is much more damaging than a human hit that you're expecting because you set your neck, you're expecting the hit and it doesn't cause the whiplash that a blindsided hit cause.

你知道，一個突然的撞擊比你預期的撞擊更有破壞性，因為你準備好了你的脖子，你預期到撞擊，它不會造成突然撞擊所引起的揮鞭傷。

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如果你喜歡 DARA CEO 這個品牌，而且你收看這個頻道，請幫我一個大忙。

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成為這個頻道 15% 的觀眾，按下訂閱按鈕。