Aging with Marfan and Related Conditions (VIrtual Medical Symposium Series, 5/6/19)
23:27-26:15
Now all of us care about the way our nervous system functions and right around the age of 75 or 80, normal people begin to notice that they're not quite as sharp with their sense of balance; about 1% of us will get Parkinson's disease. I don't know the exact lifetime risk of having a peripheral neuropathy, but they're not, they're common and people notice that their peripheral nerves are not as sharp as they were when when they were young, particularly with diabetes. And then, you know, concerning to all of us is what happens to our cognitive function.
年を取ると神経の機能が心配になってくるのですが、普通の方であれば75～80歳で安定感が無くなってきたと感じてきます。大体1%の方がパーキンソン病になります。一生のうちに末梢神経障害となるリスクは正確にはわかりませんが、よく目にしますし、若い時よりも末梢神経の感覚が鈍ったと感じるようです。糖尿病がある場合には特にその傾向があります。また、認知機能についても心配になると思います。
So there have been studies done on normal aging and cognitive function and there is some decline just in normal aging, so people can't pay attention quite as well; they process more slowly, they have an episodic memory, refers to a specific type of memory where you're remembering things along with the context, so it's a kind of a complex memory function that does decline even in normal people. Now I should say that this is extremely variable and some people have very little declined and others have more and these are normal people.
通常の加齢と認知機能に関しては研究がされており、ある程度、認知機能は低下することが分かっています。集中力が低下し、認識するのに時間が掛かるようになります。また、エピソード記憶という、状況と関連付けて物事を記憶するという記憶の一種があり、複雑な機能なのですが、通常の加齢でその能力も低下してきます。個人差があり、ほとんど低下しない方もいらっしゃいます。これらは正常な方の加齢で起こる現象です。
Now it has been shown that those who have a lifelong pattern of an active and engaged lifestyle do better and so that includes physical activity, includes mental activity and social activity, so the engaged and involved person that does better and then as we age those who maintain high levels of physical activity tend to preserve their cognitive function better than those who don't.
生涯にわたり活動的で何かに没頭するような生活スタイルを送っておられる方では、認知機能が優れているという研究があります。これには運動や精神的な活動、社会的な活動が含まれます。積極的な運動を継続して行う方では、そうでない方とよりも、年を取ってからの認知機能を維持しやすいということが分かっています。
And this is just there are many types of new imaging and I just picked one, but this is a scan that is now available here in our institution and this arrow points to the hippocampus; this is a patient with Alzheimer's disease and you can see that there. There's a lot of atrophy in the brain in general compared to the healthy normal person in the right side, but in particular hippocampus is atrophic and if you look over here on the right, that's a nice and plump normal hippocampus and the rest of the brain also does not have this atrophy that is seen in the Alzheimer patient on the left.
画像検査でも、これまでにない画像を撮影することが出来るようになりました。右の画像は脳をスキャンしたもので、赤の矢印が指す部分は海馬と呼ばれています。これはアルツハイマー病の方の画像ですが、右側の正常な脳と比較すると、全体的に萎縮しています。右側の画像にはアルツハイマー病にみられる萎縮がありません。
Now whatever, what happens if you have the Marfan syndrome or a related disorder? Well, to my knowledge, anyway from my reading of the literature, nothing has been demonstrated that said worse, so probably about the same risk as the general population.
では、マルファン関連疾患では加齢に伴ってどのようなことが起きるかということですが、私が文献を読んだ限りでは、上で説明したような機能がより悪化するということはないようです。つまり一般集団と同等のリスクと考えていいでしょう。
However, it is true though that the Marfan and related disorders patients do have more effects in the peripheral nervous system and probably because of the dural ectasia and these structural changes in the spine, so this would include impairment of sensory nerve function and with decreased the sensation, even some weakness in nerve roots, so, so this would be, I think, a challenge that is more in the Marfan syndrome and related disorders.
ですが、マルファン関連疾患の方では末梢神経に影響が出やすいようです。硬膜拡張や脊柱の変形によるものだと思われます。感覚神経が障害されて感覚が鈍ったり、神経根が弱くなる可能性もあります。以上がマルファン関連疾患の方で生じる問題となるでしょう。
The Marfan Foundation did not participate in the translation of these materials and does not in any way endorse them. If you are interested in this topic, please refer to our website, Marfan.org, for materials approved by our Professional Advisory Board.
The Marfan Foundation は、当翻訳には関与しておらず、翻訳内容に関してはいかなる承認も行っておりません。このトピックに興味をお持ちの方は、Marfan.orgにアクセスし、当協会の専門家から成る諮問委員会が承認した内容をご参照ください。
