定定聽人講：人食老毋但體力輸少年人，頭殼嘛定定會番顛失智。毋過，雖罔整體體能流失是身體老化的正常現象，咱頭殼的功能敢定著會變較䆀咧？頭殼的認知功能包含記憶力、注意力、語言、抽象思考佮判斷等等。失智症就是腦部功能退化造成種種無仝認知功能流失的症頭。伊有可能是自然的退化，嘛有可能是因為著著《神經退化性病症》(neurodegenerative disease)親像帕金森氏症(Parkinson’s)抑是阿茲海默症(Alzheimer’s)造成。
Tiānn-tiānn thiann lâng kóng: lâng tsia̍h-lāu m̄-nā thé-la̍t su siàu-liân-lâng, thâu-khak mā tiānn-tiānn ē huan-tian sit-tì. M̄-koh, sui-bóng tsíng-thé thé-lîng liû-sit sī sin-thé nóo-huà ê tsìng-siông hiān-siōng, lán thâu-khak ê kong-lîng kám tiānn-tio̍h ē piàn khah bái––leh? Thâu-khak ê jīn-ti kong-lîng pau-hâm kì-ik-li̍k, tsù-ì-li̍k, gí-giân, thiu-siōng su-khó kap phuànn-tuān tíng-tíng. Sit-tì-tsìng tō sī náu-pōo kong-lîng thè-huà tsō-sîng tsióng-tsióng bô-kāng jīn-ti kong-lîng liû-sit ê tsìng-thâu. I ū khó-lîng sī tsū-jiân ê thè-huà, mā ū khó-lîng sī in-uī tio̍h-tio̍h “sîn-king thè-huà-sìng pēnn-tsìng” (neurodegenerative disease) tshin-tshiūnn “Parkinson’s” a̍h-sī “Alzheimer’s” tsō-tsiânn.
運動避免頭殼老化 Ūn-tōng pī-bián thâu-khak nóo-huà
誠濟科學研究早就顯示：長期保持運動的習慣，是避免食老失智的好藥方。比論講今年四月瑞典一个研究團隊發表𪜶觀察1462位中年婦人人健康狀況超過40冬的論文報告，𪜶發見心肺功能勇健的人，著著失智症的年歲平均比別人慢9.5歲，暗示捷運動會使減輕甚至避免食老失智的風險。毋過這个團隊並無解說是按怎運動會當維持頭殼的認知功能閣壓制伊老化。
Tsiânn tsē kho-ha̍k gián-kiù tsá tō hián-sī: tn̂g-kî pó-tshî ūn-tōng ê si̍p-kuàn, sī pī-bián tsia̍h-lāu sit-tì ê hó io̍h-hng. Pí-lūn kóng kin-nî sì gue̍h Suī-tián tsi̍t ê gián-kiù thuân-tuī huat-piáu in kuan-tshat 1462 uī tiong-liân hū-jîn-lâng kiān-khong tsōng-hóng tshiau-kuè 40 tang ê lūn-bûn pò-kò, in huat-kiàn sim-hì kong-lîng ióng-kiānn ê lâng, tio̍h-tio̍h sit-tì-tsìng ê nî-huè pîng-kin pí pat-lâng bān 9.5 huè, àm-sī tsia̍p-ūn-tōng ē-sái kiám-khin sīm-tsì pī-bián tsia̍h-lāu sit-tì ê hong-hiám. M̄-koh tsit ê thuân-tuī pīng bô kái-sueh sī-án-tsuánn ūn-tōng ē-tàng uî-tshî thâu-khak ê jīn-ti kong-lîng koh ap-tsè i nóo-huà.
按呢，運動到底是透過啥物機制來影響腦部健康咧？針對這个問題，日本北海道大學的教授Hiroshi Maejima佇伊實驗室觀察鳥鼠仔運動對𪜶腦部功能的影響，伊發見逐工運動的鳥鼠仔有較好的認知功能，若進一步來探討伊背後的分子機制，Maejima指出：有四常咧運動的鳥鼠，𪜶腦部掌管學習佮記憶形成的hippocampus有較懸的BDNF的表現。BDNF是brain-derived neurotrophic factor的縮寫，伊具備促進《神經突觸》(synapse)形成以及支持新的神經細胞生長佮分化。Synapse是神經佮神經之間互相連接交換資訊的場所，synapse 的數量和品質決定神經網路的運作效率。因為hippocampus ni̍h的神經網路運作的好䆀決定咱學習新事物佮形成新記憶的效率，所擺咱若欲有好的學習佮記憶力，定著愛倚靠腦中有夠額的BDNF來予hippocampus形成勇健的神經synapse甚至新的神經細胞。
Án-ne, ūn-tōng tàu-té sī thàu-kuè siánn-mi̍h ki-tsè lâi íng-hióng náu-pōo kiān-khong––leh? Tsiam-tuì tsit ê būn-tê, Jit-pún Pak-hái-tō tāi-ha̍k ê kàu-siū, Hiroshi Maejima, tī i si̍t-giām-sik kuan-tshat niáu-tshí-á ūn-tōng tuì in náu-pōo kong-lîng ê íng-hióng, i huat-kiàn ta̍k-kang ūn-tōng ê niáu-tshí-á ū khah hó ê jīn-ti kong-lîng, nā tsìn-tsi̍t-pōo lâi thàm-thó i puē-āu ê hun-tsú-ki-tsè, Maejima tsí-tshut: ū sù-siông teh ūn-tōng ê niáu-tshí, in náu-pōo tsiáng-kuán ha̍k-si̍p kap kì-ik hîng-sîng ê “hippocampus” ū khah kuân ê BDNF ê piáu-hiān. BDNF sī “brain-derived neurotrophic factor” ê sok-siá, i kū-pī tshiok-tsìn “sîn-king tu̍t-tshiok” (synapse) hîng-sîng í-ki̍p tsi-tshî sin ê sîn-king-sè-pau sing-tióng kap hun-huà. Synapse sī sîn-king kap sîn-king tsi-kan hōo-siong liân-tsiap kau-uānn tsu-sìn ê tiûnn-sóo, synapse ê sòo-liōng hām phín-tsit kuat-tīng sîn-king-bāng-lōo ê ūn-tsok hāu-lu̍t. In-uī hippocampus ni̍h ê sîn-king-bāng-lōo ūn-tsok ê hó-bái kuat-tīng lán ha̍k-si̍p sin-sū-bu̍t kap hîng-sîng sin-kì-ik ê hāu-lu̍t, sóo-pái lán nā beh ū hó ê ha̍k-si̍p kap kì-ik-li̍k, tiānn-tio̍h ài uá-khò náu-tiong ū kàu-gia̍h ê BDNF lâi hōo hippocampus hîng-sîng ióng-kiānn ê sîn-king synapse sīm-tsì sin ê sîn-king-sè-pau.
科學已經證明提升BDNF的濃度會使加強鳥鼠仔和人的認知功能，佇臨床嘛發見失智症患者常常有腦中BDNF分泌不足的現象，所擺醫學界普遍認為提升腦中BDNF的量是改善失智症的好法度。欲按怎透過《運動療法》來予病人家己腦中的BDNF的量攑懸算是一種誠值得發展的新興醫療，這毋但是對失智症的病人有利，濟濟予科學家傷腦筋的神經退化症親像Parkinson’s和Alzheimer’s嘛有誠大的機會會當得著改善。
Kho-ha̍k í-king tsìng-bîng thê-sing BDNF ê lông-tōo ē-sái ka-kiông niáu-tshí-á hām lâng ê jīn-ti kong-lîng, tī lîm-tshn̂g mā huat-kiàn sit-tì-tsìng huān-tsiá siông-siông ū náu-tiong BDNF hun-pì put-tsiok ê hiān-siōng, sóo-pái i-ha̍k-kài phóo-phiàn jīn-uî thê-sing náu-tiong BDNF ê liōng sī kái-siān sit-tì-tsìng ê hó-huat-tōo. Beh án-tsuánn thàu-kuè “ūn-tōng-liâu-huat” lâi hōo pēnn-lâng ka-tī náu-tiong ê BDNF ê liōng gia̍h-kuân sǹg sī tsi̍t tsióng tsiânn ta̍t-tit huat-tián ê sin-hing-i-liâu, tse m̄-nā sī tuì sit-tì-tsìng ê pēnn-lâng iú-lī, tsē-tsē hōo kho-ha̍k-ka siong-náu-kin ê sîn-king thè-huà-tsìng tshin-tshiūnn Parkinson’s hām Alzheimer’s mā ū tsiânn tuā ê ki-huē ē-tàng tit-tio̍h kái-siān.
運動可能是Alzheimer’s患者的救星 Ūn-tōng khó-lîng sī Alzheimer’s huān-tsiá ê kiù-tshenn
Alzheimer’s disease (AD)是全球上普遍的神經退化症，伊也是上主要的失智症病因。目前全世界已經有3000外萬的患者，甚至到2050年閣會增加到一億。雖罔有遮爾仔濟的人受Alzheimer’s的苦毒，醫學界到今猶是揣無有效率的法度來治療Alzheimer’s，濟濟大藥廠親像Pfizer、Johnson & Johnson、Novartis等等，投入大量資金想欲研究出對抗Alzheimer’s的新藥，毋過定定攏是失敗，上大的因端就是Alzheimer’s的致病機制傷過複雜，閣牽涉著濟濟無仝的基因，予科學界和製藥界無法度針對某一个症頭來設計藥物。
Alzheimer’s disease (AD) sī tsuân-kiû siōng phóo-phiàn ê sîn-king-thè-huà-tsìng, i iā sī siōng tsú-iàu ê sit-tì-tsìng pēnn-in. Bo̍k-tsîng tsuân-sè-kài í-king ū 3000 guā bān ê huān-tsiá, sīm-tsì kàu 2050 nî koh ē tsing-ka kàu tsi̍t ik. Sui-bóng ū tsiah-nī-á tsē ê lâng siū Alzheimer’s ê khóo-to̍k, i-ha̍k-kài kàu-tann iáu sī tshuē bô ū hāu-lu̍t ê huat-tōo lâi tī-liâu Alzheimer’s, tsē-tsē tuā io̍h-tshiúnn tshin-tshiūnn “Pfizer”, “Johnson & Johnson”, “Novartis” tíng-tíng, tâu-ji̍p tuā liōng tsu-kim siūnn beh gián-kiù tshut tuì-khòng Alzheimer’s ê sin-io̍h, m̄-koh tiānn-tiānn lóng sī sit-pāi, siōng tuā ê in-tuann tō sī Alzheimer’s ê tì-pēnn-ki-tsè siunn kuè ho̍k-tsa̍p, koh khan-sia̍p tio̍h tsē-tsē bô-kāng ê ki-in, hōo kho-ha̍k-kài hām tsè-io̍h-kài bô-huat-tōo tsiam-tuì bóo tsi̍t ê tsìng-thâu lâi siat-kè io̍h-bu̍t.
不而過，好消息是有不止仔濟的流行病學(epidemiology)文獻顯示：保持四常運動的習慣有機會會使予咱減輕失智的風險，著Alzheimer’s的患者嘛有機會會當恢復失去的一寡認知功能。毋過問題是遮的流行病學的研究結果干焦是講運動可能有預防失智的好處，伊並無提供清楚的分子機制通來予醫生設計出治療抑是避免失智的法度，或者是幫贊藥廠開發新藥，而且運動療法佇無仝病人身軀頂的臨床試驗結論嘛是無一致，若真正想欲發展出對患者有利益的新療法，咱的確著愛先對運動和健康人抑是著Alzheimer’s的病人腦部健康的關係做一个較完整的認捌。
Put-jî-kò, hó-siau-sit sī ū put-tsí-á tsē ê liû-hîng-pēnn-ha̍k (epidemiology) bûn-hiàn hián-sī: pó-tshî sù-siông ūn-tōng ê si̍p-kuàn ū ki-huē ē-sái hōo lán kiám-khin sit-tì ê hong-hiám, tio̍h Alzheimer’s ê huān-tsiá mā ū ki-huē ē-tàng khue-ho̍k sit-khì ê tsi̍t-kuá jīn-ti kong-lîng. M̄-koh būn-tê sī tsia-ê liû-hîng-pēnn-ha̍k ê gián-kiù kiat-kó kan-na sī kóng ūn-tōng khó-lîng ū ī-hông sit-tì ê hó-tshù, i pīng bô thê-kiong tshing-tshó ê hun-tsú ki-tsè thang lâi hōo i-sing siat-kè tshut tī-liâu a̍h-sī pī-bián sit-tì ê huat-tōo, hi̍k-tsiá sī pang-tsān io̍h-tshiúnn khai-huat sin-io̍h, jî-tshiánn ūn-tōng-liâu-huat tī bô-kāng pēnn-lâng sin-khu tíng ê lîm-tshn̂g-tshì-giām kiat-lūn mā sī bô it-tì, nā tsin-tsiànn siūnn beh huat-tián tshut tuì huān-tsiá ū lī-ik ê sin liâu-huat, lán tik-khak tio̍h ài sing tuì ūn-tōng hām kiān-khong lâng a̍h-sī tio̍h Alzheimer’s ê pēnn-lâng náu-pōo kiān-khong ê kuan-hē tsò tsi̍t ê khah uân-tsíng ê jīn-bat.
Alzheimer’s的病情發展通常是對影響hippocampus的功能開始，所擺病人上頭先會感覺著家己沓沓仔咧失去學習新智識佮形成新記憶的能力，學習和記憶這兩項能力反應hippocampus功能的好䆀，也是評估Alzheimer’s病情發展的一大指標。美國Harvard大學的教授Rudolph Tanzi 利用Alzheimer’s的鳥鼠仔模型來探討運動是按怎預防認知功能衰退的機制，佇今年九月發表佇《科學》期刊的論文中，伊發見運動毋但會使促使hippocampus的神經增生閣會當促進BDNF的分泌，增加的BDNF會幫贊受Alzheimer’s蹧躂甲無適合予神經細胞做徛家的腦部環境恢復元氣，予新生的神經細胞會使生存。毋過若是干焦透過人工的法度予神經再生，並無法度改善病情，就若親像共一个紅嬰仔擲佇戰區，伊連鞭就會死去，無才調共咱鬥相共。但是若是同時落藥仔予BDNF的分泌衝懸，創造適合神經生長發展的環境，就算佇無咧運動的鳥鼠仔身軀頂，嘛看會出Alzheimer’s症狀減輕的效果，和有咧骨力運動的鳥鼠仔仝款。
Alzheimer’s ê pēnn-tsîng huat-tián thong-siông sī uì íng-hióng hippocampus ê kong-lîng khai-sí, sóo-pái pēnn-lâng siōng thâu-sing ē kám-kak tio̍h ka-tī ta̍uh-ta̍uh-á teh sit-khì ha̍k-si̍p sin tì-sik kap hîng-sîng sin kì-ik ê lîng-li̍k, ha̍k-si̍p hām kì-ik tsit nn̄g hāng lîng-li̍k huán-ìng hippocampus kong-lîng ê hó-bái, iā sī phîng-koo Alzheimer’s pēnn-tsîng huat-tián ê tsi̍t tuā tsí-piau. Bí-kok Harvard tāi-ha̍k ê kàu-siū, Rudolph Tanzi, lī-iōng Alzheimer’s ê niáu-tshí-á bôo-hîng lâi thàm-thó ūn-tōng sī án-tsuánn ī-hông jīn-ti kong-lîng sue-thè ê ki-tsè, tī kin-nî káu gue̍h huat-piáu tī “Kho-ha̍k” kî-khan ê lūn-bûn tiong, i huat-kiàn ūn-tōng m̄-nā ē-sái tshiok-sú hippocampus ê sîn-king tsing-sing koh ē-tàng tshiok-tsìn BDNF ê hun-pì, tsing-ka ê BDNF ē pang-tsān siū Alzheimer’s tsau-that kah bô sik-ha̍p hōo sîn-king-sè-pau tsò khiā-ke ê náu-pōo khuân-kíng khue-ho̍k guân-khì, hōo sin-sing ê sîn-king-sè-pau ē-sái sing-tsûn. M̄-koh nā-sī kan-na thàu-kuè jîn-kang ê huat-tōo hōo sîn-king tsài-sing, pīng bô-huat-tōo kái-siān pēnn-tsîng, tō ná tshin-tshiūnn kā tsi̍t ê âng-enn-á tàn tī tsiàn-khu, i liâm-mi tō ē sí––khì, bô-tsâi-tiāu kā lán tàu-sann-kāng. Tān-sī nā-sī tông-sî lo̍h io̍h-á hōo BDNF ê hun-pì tshìng kuân, tshòng-tsō sik-ha̍p sîn-king sing-tióng huat-tián ê khuân-kíng, tō sǹg tī bô teh ūn-tōng ê niáu-tshí-á sin-khu-tíng, mā khuànn ē tshut Alzheimer’s tsìng-tsōng kiám-khin ê hāu-kó, hām ū teh kut-la̍t ūn-tōng ê niáu-tshí-á kāng-khuán.
Alzheimer’s的新療法 Alzheimer’s ê sin liâu-huat
Tanzi的研究結果予科學家感覺誠樂暢，嘛興tshih-tshih想欲共𪜶的發見發展做治療甚至是預防Alzheimer’s的藥方，若準會當透過刺激神經再生佮增加BDNF分泌來得著和運動仝款的效果，科學界佮製藥界就會使開發出有路用的新藥來治療Alzheimer’s。而且濟濟患者年歲攏袂少，欲要求𪜶骨力運動就干焦阿婆仔生囝仝款。未來若會當予𪜶透過食藥仔來控制病情的惡化，毋但對患者本身來講是一大福音，對規个國家來講嘛會當大大減輕公共醫療支出。
Tanzi ê gián-kiù kiat-kó hōo kho-ha̍k-ka kám-kak tsiânn lo̍k-thiòng, mā hìng-tshih-tshih siūnn beh kā in ê huat-kiàn huat-tián tsò tī-liâu sīm-tsì sī ī-hông Alzheimer’s ê io̍h-hng, nā-tsún ē-tàng thàu-kuè tshì-kik sîn-king tsài-sing kap tsing-ka BDNF hun-pì lâi tit-tio̍h hām ūn-tōng kāng-khuán ê hāu-kó, kho-ha̍k-kài kap tsè-io̍h-kài tō ē-sái khai-huat tshut ū lōo-iōng ê sin-io̍h lâi tī-liâu Alzheimer’s. Jî-tshiánn tsē-tsē huān-tsiá nî-huè lóng bē tsió, beh iau-kiû in kut-la̍t ūn-tōng tō kan-na a-pô-á senn-kiánn kāng-khuán. Bī-lâi nā ē-tàng hōo in thàu-kuè tsia̍h io̍h-á lâi khòng-tsè pēnn-tsîng ê ok-huà, m̄-nā tuì huān-tsiá pún-sin lâi kóng sī tsi̍t tuā hok-im, tuì kui-ê kok-ka lâi kóng mā ē-tàng tuā-tuā kiám-khin kong-kiōng i-liâu tsi-tshut.