(37)塔斯马尼亚健康脑计划-The Tasmanian Healthy Brain Project-公开课-关爱惟士
(37)塔斯马尼亚健康脑计划-The Tasmanian Healthy Brain Project


Associate Professor Mathew Summers

The design of the Healthy Brain Project is to look at older adults over the age of 60, who re-engage in further education at university, and compare them against the same age group of adults who don’t engage at university. We will then assess and monitor their cognitive functions every year, for the next 10 to 20 years, the idea being to see whether that intake of doing some university education in older age, protects against later cognitive decline and possibly dementia.

健康大脑计划的设计是看看60岁以上的老年人重新进入大学继续接受教育,并与不在大学就读的同一年龄组的成年人进行对比。 然后我们将在未来10到20年,每年评估和监测他们的认知功能。这个想法是看看在较大年龄时接受大学教育的人是否能防止以后的认知衰退和患认知症的可能。

The Healthy Brain Project’s unique because, as far as we’re aware, it’s the only study in the world looking at education interventions with older adults. Previous studies have looked at the effect of education in young adulthood and in midlife, but no-one’s deliberately looked at an experimental trial where we apply education to older adults.

据我们所知,健康大脑计划的独特之处在于,这是世界上唯一一个针对老年人的教育干预措施的研究。 以前的研究已经研究了教育对年轻的成年人和中年人的影响,但没有人特意去做一个像我们把教育应用在老年人上的试验。

Our participants in the study are doing all sorts of courses at university. They’re doing undergraduate courses, across a range of disciplines, be that Arts, Creative Arts, Social Sciences. There are also students doing Science degrees. We also have a number of students doing postgraduate studies, both at Masters and Doctoral PhD levels, and we’ve had a number who have already graduated, both with undergraduate degrees, in law. We’ve had students graduate with their PhDs and Doctorates already.

我们的研究参与者正在大学里学习各种各样的课程。 他们有的正在进行本科课程的学习,跨越艺术,创意艺术,社会科学一系列学科。 还有的学生在攻读科学学位。 我们还有一些学生在进行硕士和博士学位的学习,我们有一些已经毕业,拿到法律本科学位。 我们也有学生已经博士毕业。

The reason we’re using university education as a means of cognitive stimulation is more than just the education component, more than just learning new information. Universities are a community, and there’s a lot of social interaction engagement that goes on within the university setting, both within the classroom and outside of the classroom. So for an older adult who may be retired, and has lost the stimulation of a workplace, going back to university re-engages them both socially, as well as intellectually, with a group of peers from all different age groups, and that sort of stimulation is what we call complex mental activity, because it’s more than just cognitive stimulation.

我们使用大学教育作为认知刺激手段的原因不仅仅是教育本身,也不仅仅是学习新的信息。大学是一个社区,在大学环境中,无论是在教室内还是在教室外都有很多社交互动参与。 因此,可能对于已经退休并且已经失去了来自工作场所刺激的老年人,回到大学重新让他们在社会上和在智力上与一群来自所有不同年龄组的人为伴,这类刺激是我们所说的复杂的心理活动,因为它不仅仅是认知刺激。

I think people might have their own subjective beliefs that certain subjects are more valuable than others. For the purposes of what we’re looking at, I don’t think that that’s likely to be true. The nature of the course, or the type of subject that you study, is probably less relevant than the amount of effort that you engage in, in doing that course. So the challenge becomes more important than the subject. If you do a subject in an area that you’ve been doing for 40 years professionally, you’re probably not going to put as much mental effort in, as if you pick up a subject you’ve never done before, and actually have to learn it from scratch.

我认为人们可能有自己的主观信念,认为某些科目比其他的更有价值。 为了我们正在观察的目的,我不认为这可能是确实如此的。 课程的性质,或你学习的科目类型,可能不如你参与那个课程付出努力的大小。 因此,挑战变得比科目更重要。 如果你在学习一个科目是在你的40年的职业专业领域里的,你可能不会投入更多的心理上的努力,就像你拾起一个你从来没有学过的科目,实际上你 要从头开始学习。

In terms of how much study do you need to do to get a benefit from the impact of study, we hypothesise that there is probably a dose-dependent effect, that the more study you do, and the more engagement you do, the more protection that that would exert. It is a hypothesis, and part of the Healthy Brain study is to test that hypothesis: is that actually true, and what’s a sufficient dose, and does the amount of dose of education that a person needs vary across individuals in some systematic way?

依据你需要做多少研究将能从研究的影响中获益,我们假设可能有个剂量依赖的效应,那就是如果你做越多的研究,参与的越多,越多的保护效果就会发挥出来。 这是一个假说,而健康脑研究的一部分就是测试这个假说:这是真的吗,什么是足够的剂量,一个人需要的教育剂量在某些系统的方式是否因人而异?

Our participants are long-suffering volunteers in the study, and we do put them through an exhaustive assessment process. So we assess all ranges of cognitive functions, both intellectual processing capacity; we’ll look at memory and new learning; we look at executive function, such as decision making, planning, and speed of information; we look at attention and language. The range of assessments that we cover, being comprehensive, takes three to four hours of testing to get through, and is equivalent to what a full, comprehensive clinical neuropsychological assessment of an individual would do. So, for each of our participants who take part in the study, they get an annual check-up of all their cognitive processes.

在我们的研究中,参与者是长期受影响的志愿者,我们把他们放在一个详尽的评估过程中。 因此,我们评估所有范围的认知功能,智力处理能力; 我们将看看记忆力和新的学习能力; 我们看看执行功能,如决策,规划和信息处理的速度; 我们看看注意力和语言。 我们涵盖的评估范围非常全面,需要三到四个小时的测试才能完成,相当于一个人全面的临床神经心理学评估。 因此,对于参与研究的每个参与者,他们都会对所有的认知过程进行年度检查。

Alongside all the cognitive testing that we’re doing, we are collecting genetic information and samples from every participant. Now that information, the DNA that we collect, enables us to look for genetic markers. Some of the key genetic markers that we’re looking for are known to be conveying risk factors for dementia, such as the APOE e4 gene. So we assess the genetic status of all our participants and that information is then combined with all the information that we’re collecting longitudinally from these participants, and we can then determine whether the education influence that we’re applying, somehow mediates or moderates or changes the risk factor associated with each genetic component.

除了我们正在做的所有认知测试,我们收集每个参与者的遗传信息和样本。 现在,我们收集这些DNA信息使我们能够寻找遗传标记。我们正在寻找的一些关键的被认为是输送认知症的风险因素的遗传标记,如APOE e4基因。 因此,我们评估所有参与者的遗传状态,然后将这些信息与从这些参与者纵向收集的所有信息相结合,然后我们可以确定我们应用的教育影响,以某种方式调解或调节来改变与每个遗传组分相关的危险因素。

The key results so far, in the Healthy Brain study, are in the early stages of the study. So we’re into four and five years of the study, of a study that should take 10 to 20 years to complete. But our preliminary results are really exciting, in that we’ve shown in the adults that have gone to university, 92% have shown an increase in language processing ability. That’s things like word knowledge and vocabulary and comprehension, the ability to use language to communicate. We’ve shown no change in other cognitive functions, such as working memory or learning. Whereas when we look at our control group, the increase in these functions is nowhere near the same. So there’s a significant improvement in language processing. That’s exciting, because what we’ve demonstrated is there is a clear increase in cognitive processing capacity following education, in older adults. As I’ve said, it’s very early. We’re still waiting, and we need to wait another 10, possibly 20 years, to see whether that then changes the long-term trajectory. We would expect, over time, as people age, cognitive functions slow. What we’re hypothesising, given this improvement that we’ve seen in the first four to five years, the rate of slowing may change in those people, so that by the time they’re in their seventies and eighties, there should be a noticeable difference now between those older adults who went to university and their controls who didn’t.


The implications, if we find what we hypothesise, that education protects against age- related decline, are actually quite significant. Education is a non-pharmacological intervention. It conveys, in and of itself, no risk to the individual. There will be no harm, from going to do further study, to the individual, and no potential side-effect from that. So, if the only side-effect is that you reduce your age-related decline, over the long-term in the 10 to 20 years, less age-related cognitive decline means improved cognitive performance. That then improves your capacity to function independently, to remain an independent adult, part of the community, and needing less support services. There are significant economic implications to our healthcare system and to our aged care system, if we can maximise the potential of every older adult to remain independently living, with minimal support services.

如果我们发现,我们所假设的教育保护免受年龄相关的、认知功能下降的影响,实际上是相当重要的。 教育是一种非药物干预。 它本身的传达对个人没有风险。从做进一步研究到个人,都没有任何伤害,没有潜在的副作用。 所以,如果有,唯一的副作用是你在长达10到20年,里减少你的年龄相关的认知功能下降,更少的年龄相关认知下降意味着提高认知表现,这将提高您独立生活的能力,保持成年人的独立性,仍然是社区的一部分,并需要较少的支持服务。如果我们可以最大限度地发挥每个老年人的潜力,以便保持独立生活和需要最小的支持服务,这将对我们的医疗系统和老年护理系统有重大的经济影响。

When we look at the research that’s been done to date, looking at cognitive stimulation in mid to late life, the evidence isn’t great, that there’s a clear benefit. Part of the reason we’re doing the Healthy Brain Project is to find that evidence. Do we actually have a beneficial effect? At this stage, the advice I would give to anyone who’s an older person whose thinking about, “Should I do this to help me?” is fairly simple. It can’t hurt. It’s not a pill. It’s not a medication. It has no side-effect. And even if it doesn’t change the trajectory of age-related decline, even if it doesn’t delay dementia, the benefits from education, in terms of learning new material, and the intangible benefits of finding new social groups, of socialising with people from different age groups and different backgrounds, can be far greater than any change to age-related cognitive decline.

当我们看看迄今为止所做的研究,看看中晚期的认知刺激,有明显的好处的证据不是很充分。我们正在做的健康大脑计划的部分原因是,为了找到更充分的证据。我们确实拥有有益的效果吗? 在这个阶段,我会给任何 在考虑“我应该做这个来帮助我自己吗?”的老人的建议是相当简单。它不会伤害任何人。 它不是一个药丸,不是一种药物。 它没有副作用。 即使它不改变年龄相关的衰退的轨迹,即使它不会延迟认知症发病,来自教育的好处,像在学习新材料,寻找新的社会群体,与来自不同年龄组和不同背景的人交往,这些无形的好处可以远远大于任何年龄相关的认知衰退的变化。