El Alzheimer es una enfermedad que comienza a manifestarse de manera lenta y progresiva. Muchas veces no somos capaces de darnos cuenta cuándo un familiar comienza a padecerla. El doctor Juan Carlos Molina sobre la enfermedad del Alzheimer, sus síntomas y cómo prevenirla.
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00:00Hello, friends of the social networks of Channel 13, how are you? Welcome to a new live together.
00:07Here we are all because we want to give a little more life to the program, which is only a little less than two hours in the air.
00:14And we want to talk, as we announced with Dr. Juan Carlos Molina, about Alzheimer's and everything that this disease entails.
00:21Also the new discovery that with a test we can know before if we suffer from this disease.
00:27So I ask you all to send us your questions now through social networks.
00:32We will be attentive to answer them. We are completely live and we warmly welcome Dr. Juan Carlos Molina. How are you?
00:40Very well, Steffi. Thank you very much for touching on issues that are relevant to the Chilean population and to the world population.
00:49Do you know that every four seconds there is a new case of dementia? Imagine.
00:54There are 200,000 Chileans already in the national survey who have some cognitive disorder.
01:03Cognition is more than memory. It is memory, judgment, reasoning, abstraction capacity.
01:09In other words, it is more than memory. And let's think four or five people per family.
01:13There are a million Chileans who suffer from problems associated with dementia, where the most common is Alzheimer's disease.
01:22Doctor, let's start with ... I have a question. For example, let's clear up the difference between Alzheimer's and senile dementia.
01:34Well, that was put aside. The term senile dementia was because it was indirectly associated with the relationship to the years.
01:44And that is a mistake. It has to do with damage. Why? Even Alzheimer's disease, depending on the chromosome that alters it, can occur even at 30 years old.
01:53Hence, it is not a senile person. So the term senile is a term that is obsolete and should not be used.
02:01And we have to talk about dementia, although the new classification tries to say major neurocognitive disorder, because people tend to stigmatize the word dementia.
02:12Dementia is not silly. Dementia is not madness. It is an inability to manage your life, where several parts of your executive action,
02:23abstraction, evocation, memory, attention, make you need care, provided in such a way that you can carry this condition in a better way.
02:36In fact, we got the same question here. I'm going to show it to you. It's from Maria Bernarda Pavez Castro.
02:43She says, is senile dementia the same as Alzheimer's? It's the same question I asked her. Can you make a summary?
02:49In fact, dementia is the inability to manage your life, and the most common, 50% of the cases, is Alzheimer's disease.
03:00And not necessarily because you get old you can have this condition. It's not the same.
03:05It's just that in the ignorance of this disease, many people call Alzheimer's dementia senile dementia.
03:14This is the moment of the 21st century, where the country is already aging, the world is aging.
03:20Let's start to delineate the concepts of dementia.
03:29One question, doctor. What are the symptoms? How can we detect them?
03:34Look, sometimes the first symptoms are not arriving at an appointment, that you forget an address, that you ask yourself several times the same thing.
03:46But sometimes one can be stressed, and that...
03:50Imagine that your brain is like a radio, and the radio doesn't sound, and they tell you, hey, the tubes in the radio are burned.
03:57And it's not that the radio is bad, it's just that someone turned down the volume.
04:00Therefore, generally what we do is apply some tests to rule out mood disorders.
04:07Because sometimes there is what is called pseudo or false depressive dementia.
04:12That is, your mood problems can also give you cognitive problems.
04:16So it's something we have to clear up.
04:19And in this context, the first manifestations are these forgetfulness or complaints of memory that can be accentuated.
04:28And that generally, in your consultation, the person arrives, the caregivers or the companions arrive,
04:36and the person who comes does not know why they come, and the caregivers tell you that they come for memory problems.
04:42When someone goes alone to consult for memory problems, they generally do not have a dementia, they generally have a depression.
04:49So it's super important to get the elements out and clean up the diagnosis a bit,
04:57because not everything is dementia, but you don't have to look superficially at what is happening.
05:06Perfect, doctor. We have another question here.
05:10Isabel Barrientos says, what tests are the minimum necessary for this diagnosis?
05:16Look, clearly, the tests have to rule out elements susceptible to reversibility,
05:27which is what reversibility is, that can be cured.
05:30Because there is reversible dementia, Estefi.
05:32For example, there may be dementia due to vitamin B12 deficiency.
05:36And you take a vitamin B12 test, and that's where you have justification, when there is a deficit, to provide that vitamin B12.
05:44When there is a thyroid hormone deficiency.
05:46It is worth saying, rule out a series of things, urinary infection, other types of problems, anemia, etc.
05:53Make a general profile, along with your clinical history.
05:57Your clinical history tells you, as John Pantaya recently did,
06:02the background of memory alteration is different.
06:05For example, it is not the same to tell you, hey Estefi, where would you leave the glasses?
06:11To tell you, Estefi, I use glasses.
06:14It is worth saying, the background of memory is much greater when I ask you if I use glasses,
06:19because it is supposed to be something that I should know.
06:22But sometimes, out of the blue, I can know where the glasses are not.
06:26So, the background of memory is important.
06:28That clinical history, that clinical history of something that has been installed progressively,
06:34plus laboratory tests,
06:36make a full geriatric evaluation.
06:40From the educational point of view, from the point of view of everything social,
06:44with whom it relates, from the mental point of view,
06:47rule out that I have a depression,
06:49and apply some tests, which is like a thermometer to see if you have a fever.
06:54None of these tests makes a diagnosis by itself.
06:57Only you add up.
06:59And an altered test, such as the mental default test,
07:03is a test that helps you to go deeper into the study.
07:06It is worth saying, in this test, I ask you,
07:09Estefi, what day of the week is it today?
07:12And you answer me, that day.
07:15What date is it today?
07:17And you will answer me that day, or you will have a flaw.
07:20Where are we?
07:22Where are we?
07:23On what floor are we?
07:24In what direction are we?
07:26In what city are we?
07:27In which region are we?
07:31For example, three words, and I tell you to repeat them,
07:34and I tell you to memorize them.
07:36And so that you forget, I'm going to do five subtractions.
07:39How much is 100 minus 7?
07:41How much is 93 minus 7?
07:43How much is 86 minus 7?
07:46How much is 79 minus 7?
07:48How much is 72 minus 7?
07:51And then I ask you that word again.
07:53Every time you get it wrong, I give you a score,
07:55which I am discounting from an item of 30 points.
07:58And if you have 22 down,
08:01it implies that you have cognitive impairment.
08:03In other words, the thermometer marked me fever.
08:06Like the thermometer doesn't tell you why you have a fever,
08:09it tells you to study.
08:11And that study, along with clinical history,
08:14laboratory tests to rule out something reversible,
08:17must be counted with a diagnosis of brain images.
08:21That's where the first image is a brain scanner,
08:26and to finish, laboratory tests, brain scans,
08:31neuropsychological evaluations,
08:34a series of tests that usually a psychologist
08:38with a specialization in neuropsychology
08:41discarding attention problems, mood problems,
08:44seeing what degree of alteration and what areas of the brain
08:48are being damaged, and you correlate
08:51if there is any type of structural damage in the scan
08:54or discarding that everything is good
08:57in the clinical exams, plus the clinical history,
09:00you pose a possible or a probable Alzheimer's disease.
09:06Or, at the level of the scanner,
09:09you can see that there is a brain tumor
09:11and deep down that disease turns into a tumor.
09:14Or there is a brain infarction,
09:16therefore it is no longer a pure Alzheimer's
09:18and it can be a mixed disease
09:21that has vascular and degenerative elements.
09:23The degenerative element is Alzheimer's disease,
09:26the vascular is something else.
09:32I'm back.
09:34Perfect, doctor, it's clear to us.
09:36Let's remind people
09:39that before answering the questions,
09:42we want to remind everyone that we are completely live
09:46for Channel 13 networks.
09:48Talking about this issue of Alzheimer's,
09:51it is an issue that can affect us all in different ways.
09:54That is why every Wednesday we want to talk
09:57with a professional and solve these doubts
10:00regarding any issue that is in contingency or not.
10:03We want to address this issue because it is important.
10:07We already have several consultations that we are going to solve
10:09from all the people who have written to us
10:11through the social networks of Channel 13.
10:13And the other thing is because, in addition,
10:15a new study was recently announced
10:18that can be carried out soon.
10:21In fact, on July 26, this study can be carried out,
10:24I think at the University of Chile,
10:26where it can be discovered in advance
10:29whether one suffers or does not have an exam.
10:31Dr. Molina promised that he would do it in the program,
10:35but due to lack of time he did not do it,
10:37so we are going to ask him a little bit
10:39what this exam is about
10:42to be able to detect Alzheimer's.
10:45That's why we're talking to him right now.
10:47So I remind you that you can send all your questions,
10:50because now we are completely live
10:52through the social networks of Channel 13
10:54and we are going to solve them talking to Dr. Juan Carlos Molina,
10:57who is joining us today here in this lab.
11:00We also remind you that every Wednesday
11:03we are going to be talking to a specialist
11:06to solve doubts here.
11:08After the program of Aquí Somos Todos,
11:10we will be solving doubts.
11:12We are also going to talk next Wednesday
11:15with our psychologist, Daniel Sánchez,
11:17about the issue that we address today
11:19of family violence, for example,
11:21so that you can prepare all your questions about it.
11:24I think we already have the doctor.
11:27Is he ready?
11:29Yes, he's in the clouds.
11:32He's in the clouds.
11:34I still don't see him.
11:37There he is.
11:39Do you see me?
11:41Oh, good.
11:44Fundamentally, what I was asking you here
11:47was how to think about Alzheimer's disease.
11:50This disease that every three or four seconds
11:53there is a new case in the world.
11:55Even studies from the University of Chile,
11:59where Andrés Lachesky is,
12:01with countries like Brazil, Argentina,
12:03showed how the pandemic even contributed
12:06to cognitive deterioration.
12:08But what recent studies mean
12:12in terms of the detection of Alzheimer's disease,
12:16there is some kind of approach,
12:20as we could say, biological,
12:24in which a Chilean participated,
12:26Dr. Ricardo Machomi,
12:28who has even been nominated for the Nobel Prize,
12:31which is a detection test, ALSTAU,
12:35which is the detection of a protein
12:39that has to do with the damage phenomenon
12:42to Alzheimer's disease, which is the tau protein,
12:45in which phosphorylation is compared,
12:48or how that protein is filled with phosphorus,
12:51comparing the circulating platelets
12:54with respect to the intracerebral platelets.
12:57And there, in the end, an arithmetic calculation is made
13:01with a model in which one could have
13:05the increased probability that that person
13:08could have, in the long run, an Alzheimer's disease.
13:12This is patented by the FDA
13:18and Dr. Machomi handed it over to humanity.
13:22There are no costs involved in its patent.
13:25And this is to tell you that, in the end,
13:29at this moment, although this can contribute
13:32and has to be clarified with the history,
13:35the clinical evaluation of an integral genetic evaluation,
13:39a neuropsychological evaluation,
13:41are the elements that allow you to research.
13:44Even, already in the world,
13:48genetic studies are being done
13:50to reach a preclinical stage,
13:52because, deep down, in the clinic, as one,
13:54many times they already reach you
13:56with the symptoms of an early stage.
14:00...that in the past three or four years
14:03would have launched the disease.
14:05Therefore, you have to take care of the mate,
14:08you have to put money in the bank,
14:10connections between neurons,
14:12for that, education, education, education.
14:15Don't hit your head,
14:17exercise,
14:19don't smoke,
14:22eat, hopefully, diets like Mediterranean,
14:26socialize,
14:28have a hobby,
14:29play an instrument,
14:30learn a language.
14:32And physical exercise contributes,
14:35decreasing the probability of dementia
14:37by 50%.
14:39Unintentionally, Estefi,
14:41I gave you the pills
14:43to preserve your brain health.
14:46With respect to whether it is a hereditary disease,
14:49it can contribute.
14:51I see it here, from Ximena Antriao.
14:55Ximena Antriao.
14:57Yes, doctor, look, Ximena Antriao
14:59wrote a little more too,
15:01so that you have a little more background.
15:03She wrote,
15:04my mother has been sick for three years
15:06and has gone through several stages.
15:08Today, as a result of the pandemic,
15:10she no longer walks,
15:11and then her question was,
15:12is this disease hereditary?
15:13Of course she worries
15:14if her mother suffers from it.
15:16Please, doctor.
15:17Sure.
15:18It has a hereditary factor,
15:20but only 15%.
15:22Therefore, those who do not have a mother
15:24like Ximena,
15:25who has a disease,
15:27with a dementia,
15:28they still have to take care of themselves,
15:30not just worry.
15:31That is, take care of your brain.
15:33That is to say,
15:34of 185,
15:36of the new dementias,
15:38they will not have the antecedent that Ximena has.
15:40Most likely,
15:41only 15%
15:43has a hereditary factor.
15:45And not necessarily,
15:46Ximena,
15:47Ximena,
15:48for having her mother with this condition,
15:50means,
15:51to a certain extent,
15:53that she is going to have this disease.
15:55However,
15:56there is a slightly higher probability
15:58that she does not have that hereditary condition.
16:01But if that person,
16:02who does not have that hereditary condition,
16:04does the opposite of what I am telling you,
16:07that she hits her head,
16:09that she does not put educational money in the bank,
16:12that she smokes,
16:14is sedentary,
16:16that she is full of cholesterol,
16:18is full of stress,
16:20does not socialize,
16:22without having any hereditary factor,
16:25increases the chances of having this same condition.
16:30Doctor,
16:31you say then that doing all this,
16:33contrary to what you are recommending,
16:35that is,
16:36if I hit my head,
16:37can Ximena cause me?
16:39Definitely yes.
16:40And if I don't take care of myself,
16:43can I atrophy in the background
16:45and can I contribute to being able to acquire this disease?
16:50Definitely yes.
16:52And this condition is very true with confinement.
16:55We have seen that people who had a cognitive level,
16:58the fact of having cut their social connections,
17:03they declined cognitively
17:06and even dementia has appeared,
17:09not because the coronavirus has put it,
17:12but as a result of the isolation of the coronavirus,
17:16they stopped receiving the connections
17:18between the interneuronal neurons
17:20that led to a greater cognitive dementia.
17:23Therefore,
17:24if someone was at the edge of the cliff,
17:26he took a step forward.
17:31Understood?
17:32Yes, it was clearly understood.
17:34We have another consultation from Elsie Corrales Vera,
17:37she says,
17:38this disease has no cure,
17:39I have worked with people who have this problem,
17:42it is very difficult to endure everything.
17:45A tribute to all caregivers,
17:48to all caregivers,
17:49who are generally caregivers,
17:51and where dad has been, he has not been.
17:55And in that context,
17:58as she says,
17:59degenerative dementia,
18:01vascular dementia,
18:02generally have no cure,
18:04but there are reversible dementias.
18:06Which ones?
18:07For example,
18:08that your scanner shows
18:10that you have a normotensive hydrocephaly,
18:12that is,
18:13that your required cephalic liquid
18:15has no discharge,
18:16and it begins to accumulate
18:18and tighten your cortex.
18:21It crushes it.
18:23So what you have to do
18:25is a surgical discharge
18:27in your brain that reaches the abdomen
18:29and this deflates,
18:31and your brain can work again.
18:34That is,
18:35it is a reversible dementia.
18:37A dementia due to hypothyroidism,
18:39detected over time,
18:41can reverse this condition.
18:43A dementia due to vitamin B12 deficiency
18:46can reverse this condition.
18:48But in general,
18:50they are irreversible characteristics,
18:52such as Alzheimer's,
18:53body-language dementia,
18:55frontotemporal dementia.
18:57I want to testify
18:58that there are more than 100 causes of dementia,
19:01only the most frequent is Alzheimer's,
19:03and we all call it Alzheimer's.
19:05But in general,
19:07those that are irreversible,
19:09that is,
19:10they have no cure and are mortal,
19:12and have an evolution of 14 years.
19:1614 years, yes.
19:18You have to be attentive.
19:19So here we have another
19:20consultation from ISA Ordenes.
19:22It says, Doctor,
19:23what signs are there of an alarm?
19:25When should the doctor be seen?
19:27When should the doctor be seen?
19:29Well,
19:30you always have to,
19:31I think we should be supporters
19:34of a Ministry of Health
19:36and not just the Ministry of Disease.
19:38That is,
19:39control me so that they tell me I'm fine
19:41and not go when the symptoms are very late.
19:44Point one.
19:45Once this is achieved,
19:47I must consult when my mood is low,
19:51when my attention is low,
19:53when my memory is low,
19:55when my behavior begins to alter.
19:58And there it is very important
20:00that most of the time
20:02a medical term occurs
20:04that I am going to translate into easy.
20:06It is called anosognosia.
20:09What is that?
20:10That I do not recognize that I have a disease
20:13and the others realize that I have a disease.
20:16Therefore,
20:17it is very difficult to take someone
20:19to a medical consultation
20:20if you do not feel sick.
20:23So,
20:24especially in dementia,
20:26there is a large percentage
20:27that does not realize
20:28that they have this condition.
20:30Therefore,
20:31the environment,
20:32the ability to approach it early,
20:35to have an effective rule,
20:37but to be looking at the amount.
20:40If someone says that it is not worth it,
20:43it means that there is already a risk of failure.
20:47But to be quantifying.
20:49I think that the people who are losing money,
20:58who have financial problems,
21:03who do not have a normal account,
21:07all of that has to make you think
21:09that there may be something behind it.
21:13Perfect, doctor.
21:14It was clear to us.
21:15Now,
21:16I want to go back a little
21:17to the previous question of Isa,
21:19it seems to me.
21:20What should the person who takes care of them do?
21:23Because suddenly,
21:24maybe they get a little aggressive,
21:26they are different,
21:27they are unknown.
21:29How, suddenly,
21:30we take care of the patient more,
21:32but not of the person,
21:33the caretaker, let's say.
21:37What should that person do?
21:40I wanted you to stick a while.
21:42Repeat the question.
21:44Repeat the question
21:45because you stuck a while.
21:47He didn't hear me.
21:48That sometimes we take care more of the patient
21:51who has Alzheimer's,
21:52and not so much of the caregiver.
21:55What precautions or care should the caregiver
21:59of this person with Alzheimer's have?
22:01Because they are also a little aggressive,
22:03suddenly.
22:05I think that sometimes the person can also get sick.
22:08What should this person do?
22:11I'm talking about caregivers.
22:14Yes.
22:15The caregiver comes from the word
22:17cognitare,
22:18which means to know.
22:20Generally,
22:21they have to take care of a type of caregiver
22:24out of love,
22:25out of retribution,
22:26which are the informal caregivers,
22:28that is,
22:29the daughter,
22:30the wife,
22:31someone who wants to shake hands,
22:33someone who was generous.
22:34But there are the formal caregivers
22:36who are paid to take care of.
22:38Unfortunately,
22:39the training of a large percentage of them
22:42is non-existent
22:44and many times they learn from...
22:47and they come from the point of view
22:49of a place advisor.
22:50Many times,
22:51the same person who was the nanny
22:53is made to take care of a person with dementia.
22:57So,
22:58the caregiver comes from cognitare,
22:59to know.
23:00Therefore,
23:01if they don't know,
23:02they don't know the disease,
23:04they don't have the aptitude
23:06or the attitude,
23:07and the stress increases.
23:09And that stress can be given
23:11in both types of caregivers.
23:13In the informal caregiver,
23:15the daughter,
23:16the wife,
23:17and in the formal caregiver.
23:18And that stress of the caregiver,
23:21we should give him a societal hand.
23:24That informal suffers
23:27depression,
23:28social isolation,
23:30stops working,
23:31stops sleeping well,
23:33increases his tranquilizer consumption,
23:36has lumbar problems,
23:39has...
23:40increases the probability of cross-infections.
23:44However,
23:45that stress of the caregiver
23:46and all the appearance of diseases
23:48that can be occurring here,
23:50in that person,
23:51it gives him anger,
23:52it gives him frustration,
23:53but he doesn't act against the patient.
23:55However,
23:56the formal caregiver,
23:58to whom we pay for care,
24:00can suffer the same,
24:01but has a higher probability
24:03of abuse and mistreatment
24:05in front of the caregiver.
24:07That's why
24:08it is tremendously important
24:10the instances of training
24:12in knowledge
24:13to understand the disease.
24:15Also,
24:16the instances of support
24:17and support to caregivers
24:19so that they have breath.
24:21Because sometimes it is defined
24:23that these caregivers
24:24have to work 36 hours a day.
24:28And that physical,
24:30emotional,
24:31mental wear
24:32goes to such an extreme
24:34that if the person is totally...
24:36As it happens,
24:37as the disease progresses,
24:39because in a first stage
24:40the caregiver says,
24:41no, don't do this,
24:42be careful not to fall.
24:44But then,
24:45the caregiver becomes
24:47the spoon that feeds him,
24:48the comfort that cleans him,
24:50the soap that bathes him,
24:52the blanket that covers him.
24:54That is to say,
24:55as the functionality
24:57of the person with dementia
24:59decreases,
25:00the burden of the caregiver increases.
25:02That's why
25:04the support,
25:05doing all the things,
25:07makes the person
25:09lose functionality.
25:11Therefore,
25:12the best way to take care of it
25:14is to try to maintain
25:15the functionality as long as possible.
25:18And where the existing drugs
25:20to date
25:21are the hope
25:23of a match,
25:25of a match
25:26inside a tunnel
25:27of three kilometers of darkness,
25:29are only palliative drugs.
25:32They have not changed
25:33over the course of history.
25:35Therefore,
25:36the non-pharmacological
25:38becomes more important
25:40than the pharmacological.
25:42Hence the call,
25:43here,
25:44and with this I congratulate Channel 13,
25:46to generate an educational instance
25:48for caregivers
25:49is more important
25:50in these moments
25:51than having a drug
25:53for this condition.
25:55And generally,
25:56the drugs that are used
25:57are for the symptoms.
25:59When you said very well
26:01there was a moment of aggressiveness,
26:03you can use drugs,
26:04especially neuroleptics,
26:06to reduce that aggressiveness.
26:08If you have insomnia,
26:09something to produce more sleep.
26:12And so,
26:13to see,
26:14but deep down,
26:15in the course of the disease,
26:16the drugs have not changed history.
26:18And that is why it is so important
26:20to educate,
26:21to talk about this topic,
26:23to talk about it,
26:25not to make conjectures
26:27by trial and error,
26:28because both the caregiver
26:30and the caretaker patient,
26:32in the case of
26:33when the caregiver claudicates,
26:34when it is burst,
26:35for example,
26:36a patient who is postponed
26:37with dementia,
26:39the claudication of the caregiver
26:41becomes evident
26:42by the appearance of ulcers
26:43by pressure
26:44or injuries by pressure
26:45that people call scara.
26:47That is to say,
26:48the person is so exhausted
26:50that he cannot change position.
26:52And there you realize
26:53that we are reaching
26:55a debacle
26:56of the patient
26:57and the environment.
27:00Yes, I understand, doctor.
27:02That happens.
27:03I want to comment here,
27:04Ximena,
27:05I think she also made other comments.
27:09She said,
27:10despite all the years
27:11that my mother has been,
27:12she still shows
27:13certain motor skills.
27:14She is affectionate,
27:15sometimes she manages to eat alone.
27:16Brain mapping
27:17was decisive
27:18in my mother's diagnosis,
27:19since when she was young,
27:20she fell off a horse.
27:21And I also ask,
27:22later,
27:23to see if I can put it,
27:24here it is,
27:25what is,
27:26no,
27:27brain mapping,
27:28what is it for?
27:29I had not heard this.
27:31She probably interpreted
27:34what the analysis means,
27:38both by cognitive evaluations
27:40of different areas of the brain,
27:43as well as an anatomical analysis
27:45with what the images mean.
27:48Both the scanner
27:49and the nuclear magnetic resonance
27:51and tests
27:52of how the brain works,
27:54which are called SPEC, PET, etc.,
27:57in the sense of seeing
27:58areas that capture
27:59more glucose
28:00at the level of the brain,
28:02which are more advanced exams
28:04that exist,
28:05but which, deep down,
28:07are done in certain cases,
28:11but for practical purposes,
28:13the non-pharmacological
28:15to make it transcendental
28:17and to be able to better understand
28:19this situation.
28:20Deep down,
28:21this ignorance
28:22makes our people,
28:25when they realize
28:26that a person suddenly
28:27cannot speak,
28:28but when he gets angry,
28:29he speaks perfectly,
28:30the caregiver can say,
28:32of course,
28:33to challenge me
28:34or to tell me a joke,
28:35everything is fine.
28:36And we can understand
28:37that this word
28:38comes out of an area
28:39of your brain
28:40that is not bombarded,
28:41which is the emotional area,
28:43the limbic area.
28:45Therefore,
28:46there are studies,
28:47more than studies,
28:48evidence,
28:49which we have even seen
28:50on this same channel,
28:51where a dancer,
28:53listening to the music
28:54of the Lake of the Swans,
28:56repeated the same movements
28:58and connected,
28:59after being totally disconnected,
29:02because it comes
29:03from a connection,
29:04from the emotional,
29:06and that emotion
29:07can be a connection
29:08from anger
29:09or joy,
29:11which is much greater
29:12than in the day to day.
29:13That is why it is so important
29:15to develop strategies
29:16to maintain that contact
29:18that is being lost,
29:20resort to biography
29:21and know the biography
29:22of that person
29:23to be able to stimulate it.
29:27Yes, doctor,
29:28it was clear to us.
29:29We have...
29:30This is going to be
29:31the last question.
29:33Is Alzheimer's a serious disease?
29:36Very serious.
29:37It is a deadly disease.
29:39It is a degenerative,
29:42progressive disease
29:43that makes you lose
29:44the self-confidence
29:45and the ability
29:46to decide about your life.
29:48So, in this,
29:49there are elements
29:51that make early detection
29:53important
29:54and knowing
29:55that you are going to have
29:56this disease
29:57and know the course
29:58of this disease
29:59so that you give
30:00early guidelines
30:01to your family
30:02so that they say,
30:03no,
30:04I don't want such a thing,
30:05I don't want
30:06an institution
30:07or if I want,
30:08I want them to do this
30:09with me.
30:10I want,
30:11from a practical point of view,
30:12my legal part
30:13to be fixed.
30:15I want to leave
30:16this inheritance to you.
30:17I want this house
30:18not to be occupied
30:19by this person.
30:20All those points
30:21have to be discussed
30:22and touched
30:23in the face
30:24of a disease
30:25that progresses
30:26and that will lead you
30:27irrevocably
30:28to death,
30:29but that,
30:30deep down,
30:31in this step
30:32along the way,
30:33in this step
30:34of care,
30:35be with dignity,
30:36with value,
30:37with respect.
30:38And where
30:39this care,
30:40most of the time,
30:41requires
30:42the commitment
30:43of the people
30:44who are in the environment,
30:45which most of the time
30:46is
30:47a Tarakiri
30:48and where
30:49the patient
30:50has to be
30:51willing
30:52to be
30:53treated,
30:54willing
30:55to support them
30:56because,
30:57generally,
30:58they isolate themselves,
30:59suffer from this condition
31:00and we have to
31:01keep moving forward
31:02in medicine
31:03trying to give
31:04therapeutic answers
31:05to give a better
31:06quality of life
31:07and a better quality
31:08of death
31:09to these patients.
31:10Thank you very much,
31:11doctor.
31:12Thank you,
31:13Pablo,
31:14too,
31:15for asking that question.
31:16Well,
31:17we want to thank you
31:18for your time,
31:19doctor,
31:20because we know
31:21that you already
31:22have a science
31:23that is
31:24very important
31:25for the
31:26medical community
31:27and we
31:28know that
31:29you are
31:30aware of
31:31your challenges
31:32and you
31:33are
31:34also
31:35aware
31:36of
31:37your
31:38challenges
31:39and
31:40your
31:41work
31:42and
31:43your
31:44work
31:45and
31:46your
31:47work
31:48and
31:49your
31:50work
31:51cardiovascular diseases, hypertension, diabetes, cholesterol, sedentary lifestyle, stress,
31:57develop a new language.
32:00As soon as possible is better, but it is never too late.
32:04Stimulate yourself, stimulate yourself.
32:06Your brain is a fertile ground.
32:09Keep using it, occupying it.
32:13When a hypoxia appears,
32:16occupy the ear, occupy the lens,
32:19stay active, stay active.
32:22With you, channel 13,
32:25here educating you, and we will continue in this crusade.
32:29Thank you very much, doctor, for your time,
32:31and thank you to everyone who connected and made their inquiries.
32:34We will meet again next Wednesday
32:36with a new specialist in this live post.
32:39Here we are all. See you soon.
32:42Bye, doc.
32:43Bye, bye.