Transcript: Guy Proulx on Geriatric Care - Wisdom Versus Dementia | May 11, 2003

Guy Proulx stands on a stage in a university auditorium giving a lecture. He is in mid-fifties, clean-shaven with receding black hair. He’s wearing glasses, a black suit jacket and an open-necked light purple shirt.

Behind him, a computer screen is projected on a tall white wall.

Guy looks at a PowerPoint slide and says
AND I THINK OUR
MESSAGE THIS EVENING, IS YOU
KNOW, NUMBER ONE, DEMENTIA IS
NOT, I REPEAT IS NOT NORMAL
AGING.
OKAY?
DEMENTIA IS A PROGRESSIVE,
FATAL, MEDICAL DISEASE, AND
AGING IS A, IS A PRIVILEGE.
THERE ARE NO MEDICAL CURES YET,
BUT THE COMBAT, THE COMBAT TO
FIND A CURE IS PROGRESSING AND
IN VERY IMPRESSIVE WAYS AS
WE'LL SEE.
COMPENSATION STRATEGIES CAN
IMPROVE QUALITY OF LIFE, VERY,
VERY DRAMATICALLY.
AND EARLY DETECTION AND EARLY
INTERVENTION IS WHERE WE'RE
GOING.
AND THERE'S A NEW KID ON THE
BLOCK WHEN WE'RE DEALING WITH
DEMENTIA IS MCI, AND YOU'LL
HEAR AND READ A LOT ABOUT THIS
IN NEWSPAPERS IN THE COMING
YEARS.
MCIS REFERS TO MILD COGNITIVE
IMPAIRMENTS.
AND THE BOTTOM LINE WITH THAT
IS THAT WE'RE BEGINNING IN OUR
RESEARCH, CLINICAL RESEARCH, TO
SEE PEOPLE NOW SIX YEARS, SIX
YEARS BEFORE YOU SEE THE FULL
BLOWN, FULL BLOWN SYMPTOMS OF
DEMENTIA, AND THAT'S WHERE
THINGS ARE GOING.
NOW, UM, A FEW, A FEW
DEFINITIONS.
DEMENTIA, THERE ARE TWO
CRITERIA THAT DEFINES DEMENTIA.
THE FIRST ONE IS WE'RE TALKING ABOUT...

Guy says THESE ARE
DISEASES OF THE MIND.
THEY ROB YOU OF YOUR THINKING
AND OF YOUR MEMORY.

He turns to read the slides projected.

He continues THE SECOND CRITERIA IS THAT
PEOPLE, PATIENTS, BECOME
DEPENDENT ON OTHERS IN THEIR
ACTIVITIES OF DAILY LIVING.
SO, WHEN WE TALK ABOUT, SO,
THESE ARE PRETTY GENERAL, THIS
IS QUITE GENERAL.
SO, THE QUESTION NOW IS WHAT,
WHAT TYPE OF DEMENTIA ARE WE
TALKING ABOUT?
WELL, THE ONES WE'LL BE
STRESSING TONIGHT IS
ALZHEIMER'S, BECAUSE IT
REPRESENTS 50 percent OF ALL THE
DEMENTIAS.
WE'LL BE TALKING ABOUT VASCULAR
DEMENTIA.
THAT REPRESENTS 30 percent OF ALL THE
DEMENTIAS.
AND THE REST OF THE 20 percent ARE A
WHOLE LIST OF OTHER DISEASES
LIKE HUNTINGTON'S DISEASE,
WILSON'S DISEASE.
AH, FRONTAL, TEMPORAL
DEMENTIAS, POLYGLUCOSAN BODY
DISEASE AND, AND MANY MORE.
SO, BUT WE'LL FOCUS ON THE, ON
THE 80 percent OF ALL DEMENTIAS.
NOW, ANOTHER DEFINITION
COGNITION, COGNITIVE DISORDERS.
IT'S THE ABILITY OF THE BRAIN,
COGNITION IS THE ABILITY OF THE
BRAIN, SO UNDERLINE THE WORD
BRAIN HERE, TO REGISTER, TO
STORE AND RETRIEVE INFORMATION
IN ORDER TO SOLVE PROBLEMS IN
EVERY DAY.
OKAY.
NOW, I, SO, SO COGNITIVE
FUNCTIONS LIKE MEMORY,
PERCEPTION, LANGUAGE, ARE NOT
DISCONNECTED FROM OUR BRAIN.
OKAY?
SO, YOU NEED IT TO REGISTER, TO
PAY ATTENTION.
TO STORE AND PROCESS
INFORMATION, AND ALSO TO
RETRIEVE.
DIFFERENT DISEASES AFFECT THE
BRAIN IN DIFFERENT AREAS, AND
THOSE DIFFERENT BRAIN AREAS
WILL AFFECT COGNITION,
COGNITIVE FUNCTIONS IN VERY
DIFFERENT WAYS.
THEREFORE THE INTERVENTIONS,
THE CURE, THE TREATMENT WILL
ALL VARY ACCORDING TO WHERE THE
DISEASE IS IN THE BRAIN.

He uses a laser pointer to point at a new slide.

He continues AND IN TERMS OF STATISTICS, ALL
CANADIANS 65 TO 74, TWO PERCENT
OF PATIENTS, OF PEOPLE,
CANADIANS HAVE ALZHEIMER'S.
SO, HERE YOU HAVE IT.
OKAY, HERE'S AN EXAMPLE.
A LOT OF PEOPLE THINK IF YOU
LIVE OLD ENOUGH, YOU'LL GET
DEMENTIA.
THIS IS WRONG.
THIS IS NOT TRUE.
FORGET ABOUT THAT.
SO, THAT MEANS 98 percent OF ALL
CANADIANS, 65 TO 74 DO NOT HAVE
ANY, ANY PROGRESSIVE
NEUROLOGICAL DISEASE AFFECTING
THEIR MIND.
OKAY?
MANY ARE SHARP AS WHISTLES.
NOW, WHEN YOU, WHEN YOU GET TO
75 TO 84, 11 percent, SO THOSE
STATISTICS REALLY JUMP OUT.
ALL OF CANADIANS 85 AND OVER,
IF YOU MAKE IT TO 85, ALMOST
FOUR OUT OF TEN PEOPLE, 35 percent OF
ALL US IN THIS ROOM IF WE MAKE
IT TO 85, WILL, WILL, WILL DIE
FROM DEMENTIA.
SO, YOU KNOW, THIS IS VERY,
VERY SERIOUS.
NOW, IF YOU PULL ALL THESE
TOGETHER AND YOU LOOK AT ALL
THE CANADIANS, WE'RE TALKING
ABOUT EIGHT PERCENT OF, OF, OF
CANADIANS AND INDUSTRIALIZED
COUNTRIES SUFFER FROM
DEMENTIAS.
DEMENTIAS ARE DISEASES OF THE
MIND.
WHERE, WHAT IS THE MIND?
OKAY?
I MEAN THAT'S A THOUSAND DOLLAR
QUESTION, MILLION DOLLAR
QUESTION.
WHERE IS THE MIND?
WHAT IS THE MIND?

A slide shows the picture of a brain next to a caption that reads "Where is the mind?" and the picture of the inside of a radio next to a caption that reads "Where is the music?"

He continues TO TRY TO LOOK INTO THE BRAIN
TO FIND THE MIND IS A BIT LIKE
OPENING UP A RADIO AND LOOKING
FOR THE MUSIC.
RIGHT?
WHERE IS THE MUSIC?
MAYBE IT'S IN THIS FRONTAL PART
RIGHT OVER HERE, OR MAYBE IT'S
IN THIS RECTAL PART.
THESE ARE MEDICAL TERMS.
RECTAL PART, IN THE BACK.

[Audience laughing]

Guy continues IT MEANS, BELOW.
OR IN THE MIND.
OKAY?
OUR CONSCIOUSNESS, SOMETIMES
WHEN YOU READ ALL THESE FANCY,
THE LITERATURE OUT THERE AND
NEWSPAPERS, IT LOOKS LIKE
CONSCIOUSNESS OVER HERE, HUMOUR
IS IN THIS FRONTAL PART HERE.
LANGUAGE OF COURSE IS IN, IN
TEMPORAL, TEMPORAL REGIONS OF
THE BRAIN, OF THE CORTEX HERE.
PERCEPTION IS OVER HERE.
I MEAN, IF MOTOR SKILLS LIKE
PIANO PLAYING AND IS IN THE
CEREBELLUM DOWN HERE.
I MEAN IT, IT, IT CAN'T BE THAT
SIMPLE.
RIGHT?
SO, WHAT IS THE MIND?
WELL, THE MIND PEOPLE SAY,
SCIENTISTS SAY, PEOPLE SAY, THE
MIND IS WHAT THE BRAIN DOES.
NOW, THE QUESTION IS, WHAT DOES
THE BRAIN DO, RIGHT?
WELL, OVER MILLIONS OF YEARS OF
EVOLUTION, THE HUNDREDS OF
MILLIONS OF YEARS THAT BRAINS
HAVE EVOLVED FROM SMALLER
ANIMALS TO, TO HUMANS, THE, THE
BRAIN HAS DEVELOPED VERY, VERY
COMPLEX BEHAVIOURS IN ORDER TO
INTERACT AND TO ADAPT TO ITS
ENVIRONMENT.
OKAY, DID YOU KNOW, DID YOU
KNOW THAT ONLY ORGANISM, LIVING
ORGANISMS THAT MOVE IN SPACE,
THAT EXPLORE THEIR ENVIRONMENT
HAVE BRAINS.
ANY LIVING ORGANISM THAT
DOESN'T MOVE IN SPACE, OKAY,
EXCEPT MY FATHER-IN-LAW.

[Laughter]

Guy says IF IT DOESN'T
MOVE IN SPACE, OKAY, DOES,
DOES, IT HAS A BRAIN, OKAY.
SO, WE'LL BE LOOKING AT THOSE
THREE ANGLES TO UNDERSTAND, THE
THREE ANGLES TO UNDERSTAND THE
MIND.
YOU HAVE TO LOOK AT THE THREE
ANGLES OF BRAIN, BEHAVIOUR,
ENVIRONMENT TO UNDERSTAND THE
COMPLEXITIES OF THE AGING MIND
AND OF DEMENTIA.
SO, THIS IS WHAT A REAL BRAIN
LOOKS LIKE, EXCEPT OF COURSE
FOR THE ASTRONAUT.
AH?

[Audience laughs]

A slide displays the picture of a brain floating in space with an astronaut on top.

Guy continues AND ALSO THE
arteries HAVE BEEN TAKEN OUT.
OKAY?
SO, THE ARTERIES HAVE BEEN
TAKEN OUT.
THIS IS A REAL, REAL BRAIN AND
THE MOST, THE, THE SINGLE MOST
COMPLEX OBJECT IN THE KNOWN
UNIVERSE IS THE HUMAN BRAIN.
IF THE BRAIN WAS NOT AS COMPLEX
AS IT IS, WE COULD NOT
UNDERSTAND IT, STUDY IT, SO
THAT OUR HUMAN BRAINS HAVE
STUDIED HUMAN BRAINS.
IF THE BRAIN WAS NOT
COMPLICATED, WE COULDN'T DO
THAT.
LET ALONE, LET ALONE
UNDERSTANDING THE UNIVERSE AND
THE WORLD AROUND US.
THIS IS AN EXTRAORDINARILY
COMPLICATED MACHINE.
NOW, THERE ARE DIFFERENT
GEOGRAPHICAL ZONES IN THE
BRAIN, OF TEMPORAL LOBES, OF
FRONTAL LOBES HERE, FRONTAL
CORTEX, TEMPORAL CORTEX,
CORIDAL, OCCIPITAL CORTEX AND,
AND WHAT THE WORD CORTEX IN
GREEK MEANS, A BARK OF A TREE.
ANOTHER WORD THAT WE USE IS
THAT, THIS CORTEX, WHICH IS
THE, THE, THE THICKNESS OF, OF
AN ORANGE PEEL.
VERY THIN, AND IT HAS IN THAT
LAYER, OKAY, THAT COVERS THE
BRAIN, 100 BILLION NEURONS.
THAT'S A LOT OF NEURONS.
OKAY?
100 BILLION NEURONS AND THOSE,
THIS AREA, THOSE, THIS CORTEX
WE OFTEN, WE REFER TO THAT AS
ASSOCIATION AREAS OF THE BRAIN.
SO, ALL THE HIGHER MENTAL
FUNCTIONS TAKE PLACE IN THOSE
ASSOCIATION AREAS OF THE BRAIN.
AND GUESS WHAT BREAKS DOWN IN
DEMENTIA?
THOSE ASSOCIATION AREAS OF THE
BRAIN.
SO, I WANT TO TEACH YOU NOW,
I'LL EXPLAIN TO YOU, THE, THE
CONNECTION ABOUT COGNITIVE
DISORDERS AND BRAIN DISEASE.
HOW THEY AND BEHAVIOUR ARE
LINKED.
OKAY?
WELL, IF YOU HAD DAMAGE IN THIS
ASSOCIATION HERE, BECAUSE YOU
HAD MULTIPLE STROKES, VASCULAR
DEMENTIA OR ALZHEIMER'S, RIGHT,
YOU HAD DAMAGE OVER HERE, YOU
WOULD HAVE A COGNITIVE DISORDER
OF WHAT WE CALL ALEXIA.
INABILITY TO READ.
WE'D HAVE A SEVERE READING
PROBLEM.
NOW, SO, I'LL, I'LL DO THIS
TEST WITH YOU.
I'LL SHOW YOU THIS NEXT SLIDE.
OKAY?
AND I'M GOING TO SHOW YOU AS IF
YOU DIDN'T HAVE BRAIN DAMAGE,
WHICH I DON'T THINK YOU DO.
OKAY?

A slide reads "Apple."

He continues SO, WHAT YOU SEE THERE ARE JUST
SYMBOLS, AND AUTOMATICALLY WHAT
YOU DO IS YOU MAKE ASSOCIATIONS
OF THE FACT THAT THIS COULD BE
GREEN, IT COULD BE RED, IT
COULD BE YELLOW.
IT'S, IT'S A FRUIT AS OPPOSED
TO A VEGETABLE.
IT'S HARD.
IT GROWS IN TREES.
SOME ARE CALLED GRANNY SMITH.
OTHERS ARE, ARE CALLED
MACINTOSH.
THEY FALL IN THE AUTUMN.
YOU CAN MAKE APPLE PIE.
ALL THESE CONNECTIONS,
ASSOCIATIONS ARE MADE
AUTOMATICALLY.
IF YOU HAD DAMAGE IN THAT AREA
LIKE IN ALZHEIMER'S DISEASE,
YOU WOULD LOOK AT THAT AND IT
WOULD MAKE ABSOLUTELY NO SENSE.
YOU COULDN'T MAKE THOSE
CONNECTIONS, AND THAT'S WHAT
COGNITIVE DISORDERS ARE.
WHEN YOU HAVE DAMAGE THERE, YOU
CAN'T MAKE THOSE ASSOCIATIONS.
THIS IS WHAT EXPLAINS COGNITIVE
DISORDERS.
NOW, I'M GONNA SHOW YOU ANOTHER
SET OF SYMBOLS.
JUST TO SHOW YOU HOW
COMPLICATED AND WONDERFUL ALL
THIS IS AND HOW WE'RE LEARNING
SO MUCH.
ANOTHER SET OF SYMBOLS, SAME,
SAME THING, OKAY, BUT A LITTLE
DIFFERENT.
OKAY?

The caption changes to "Pomme."

He continues WHOA, EN FRANCAIS, YOU GUESSED
GUY PROULX IS FRANCAIS.
NO?

[Audience laughs]

Guy continues IF LANGUAGE WAS
IN THE BRAIN, YOU KNOW WE'D ALL
BE FRENCH IN CANADA.

[Audience laughing]

Guy continues SO BASICALLY,
WHAT'S FASCINATING IS THAT
EVERY SINGLE HUMAN IN THE
WORLD, AND, AND IN OUR WORLD,
OKAY, IN OUR WORLD, ALL THE
COUNTRIES AND ALL THOSE
LANGUAGES, WE ALL HAVE ONE
THING IN COMMON.
WE DON'T USE MORE THAN 30 BASIC
SOUNDS, 35, 36 ON THE AVERAGE
SOUNDS, EVERY HUMAN BEING IN
THE WORLD.
SO, THOSE SOUNDS, WE
ARBITRARILY COMBINE THEM TO
ASSOCIATE THEM TO OBJECTS IN
OUR WORLD AND IN OUR UNIVERSE.
SO, YOU KNOW, SOMETIMES YOU
SAY, I COULD REMEMBER THAT
FACE, BUT I CAN'T REMEMBER THAT
NAME.
WORDS, NAMES AND WORDS, IT'S
KIND OF NORMAL TO FORGET MY
NAME TOMORROW MORNING.
IT'S ARBITRARY.
GUY IS ARBITRARY.
ANOTHER REASON WHY WE'RE, WE'RE
LEARNING SO MUCH AND WE'RE
ADVANCING SO MUCH IN OUR
KNOWLEDGE IN THE FIELD OF
COGNITIVE DISORDERS IS NEW
TECHNOLOGY.
WHAT THIS IS SHOWING YOU HERE
IS A, IS A, IS A, WHAT WE CALL
AN FM, AN FMRI, WHICH SHOWS YOU
FINE DETAILS OF THE BRAIN,
SUPER-IMPOSED WITH PET SCANS.
OKAY?
NOW, WHEN I SHOWED YOU THOSE
SYMBOLS, RIGHT, WHAT YOU DID
AUTOMATICALLY IS THAT IN THE
BRAIN AT 100 MILLISECONDS, SO
IT TAKES 100 MILLISECONDS TO
GET OVER HERE.
YOU TAKE ONE SECOND AND CUT IT
INTO ONE THOUSAND SLICES.
THOSE MACHINES COULD DO THAT
FROM ONE MILLISECOND TO 300
MILLISECONDS.
100 MILLISECONDS IN THE VISUAL
ASSOCIATION AREA OF THE BRAIN,
AT THE OCCIPITAL REGION HERE.
100 MILLISECONDS LATER IN THE
FRONTAL REGION, WITH ALL THIS
INFORMATION ABOUT THE APPLE WAS
ALL PULLED TOGETHER.
AND ANOTHER 100 MILLISECONDS IN
THE MOTOR CORTEX TO SAY THE
WORD, APPLE.
EVERY WORD THAT COMES OUT OF MY
MOUTH TAKES 300 MILLISECONDS.
ABOUT A QUARTER OF A SECOND TO
COME OUT, AND WE ARE ALL
CALIBRATED TO INTERACT AT THAT
LEVEL.
SO, WE THINK IT'S PRETTY
AUTOMATIC AND PRETTY IMMEDIATE.
BUT LET ME TELL YOU, IN THE
BRAIN, IN THE BRAIN, NEW
TECHNOLOGY, 300 MILLISECONDS IS
A HELL OF A LONG TIME.
OKAY?
SO, NOW WE HAVE THE TECHNOLOGY
TO, TO SEE ALL THESE MINUTE
DETAILS.
SO, WE HAVE A BETTER
UNDERSTANDING OF THE BRAIN, AND
THE DISEASED BRAIN, AND THAT
HAS EXPLAINED A LOT OF THE BIG,
BIG, CHALLENGE, AH, PROGRESS
THAT WE'RE DOING IN THE FIELD.
SO, THE BRAIN IS AN INFORMATION
PROCESSING MACHINE.
OKAY?
A VERY COMPLEX, COMPLEX
MACHINE, AND YOU KNOW, WITH THE
DISCOVERY OF DNA AND THE DOUBLE
HELIX, OKAY, THERE ARE MILLIONS
OF PROGRAMS THAT ARE HARD
WIRED.
OKAY?
WE DON'T HAVE TO THINK TO
BREATHE.
WE DON'T HAVE TO THINK TO, TO
WALK, TO CRY, TO LAUGH.
THESE ARE HARD WIRED.
THEY'VE BEEN WITH US FOR, FOR
TENS OF MILLIONS OF YEARS.
OKAY?
SO, THERE'S MANY, MANY, MANY
PROGRAMS OUT THERE.
NOW, THE BRAIN IS AN
INFORMATION PROCESSING BEYOND
THE GENETIC SYSTEM.
EXTRA, GENETIC INFORMATION
PROCESSING.
WHERE?
AT THE LEVEL OF THE ASSOCIATION
AREA.
AT THE LEVEL OF THE CORTEX.

A picture shows a 3D image of neurons.

He continues 100 BILLION OF THOSE NEURONS.
NOW WE HAVE TECHNOLOGY TO BE
ABLE TO SEE THAT, AND WHEN WE
TALK ABOUT DEMENTIA LIKE
ALZHEIMER'S, IT'S AT THIS
LEVEL.
THESE ARE THE ONES THAT DIE
OUT.
100 BILLION OF THOSE, WITH UP
TO 100,000 CONNECTIONS BETWEEN
ONE COULD HAVE YOU KNOW, FROM
TEN THOUSAND TO 100 THOUSAND
CONNECTIONS WITH OTHER, THAT'S
A LOT.
YOU MULTIPLY THAT.
THAT'S MORE STARS THAN THERE IS
IN OUR UNIVERSE, OKAY.
SO, NOW WHAT, IN THIS
INFORMATION PROCESSING MACHINE
IT'S ALL THAT WE LEARN,
EVERYTHING THAT WE LEARN HAS TO
BE CONNECTED, ASSOCIATED AT THE
LEVEL OF THE CORTEX.
THE HUMAN MACHINE ALSO DOES
INFORMATION PROCESSING EVEN THE
CORTEX, EVEN BEYOND THE BODY.
WE CALL IT, LET'S CALL IT EXTRA
SOMATIC, EXTRA BODY INFORMATION
PROCESSING.
SO, WE HAVE ALL THESE, KNOW
THIS KNOWLEDGE.
WE ARE MEANING, MAKING,
MACHINES.
WE CREATE CULTURE, AND CULTURE
ARE HABITS.
OR WHAT I CALL COGNITIVE
PREFABS THAT OLDER GENERATIONS
PASS ONTO US, SO WE CAN SAVE A
LOT OF TIME.
WITH HOPEFULLY FROM ONE
GENERATION, THOSE USEFUL HABITS
CAN WHAT?
HELP US IMPROVE THE CONDITION
OF LIFE AND HELP US IMPROVE
WITH THIS EXTRA WISDOM TO CURE
TERRIBLE DISEASES LIKE
DEMENTIA.
NOW, LET'S LOOK AT THE BIT THAT
HOW THE BRAIN AND NORMAL AGING.
OKAY?
A LITTLE BIT.

A new slide under the title "Recall-Reading" appears. It displays two human brain scans, one that reads "Younger adults" and another one that reads "Older adults."

He continues THIS WAS A REMARKABLE STUDY BY
A COLLEAGUE OF MINE, DR. CHERYL
GRADY AT BAYCREST, AND WHAT SHE
FOUND, SHE TOOK A GROUP OF
YOUNG ADULTS.
OKAY?
YOUNG ADULTS AND COMPARED TO A
GROUP OF HEALTHY, OKAY, OLDER
ADULTS IN THEIR 70S.
WHAT SHE DID IS SHE PRESENTED
THEM WITH SHORT, VERY SHORT
SENTENCES TO REMEMBER.
AND FIVE MINUTES LATER, SHE
WOULD ASK THEM TO RECALL THOSE
SHORT STORIES.
THE BLACK CAT JUMPED OVER THE
GARBAGE CAN, FOR EXAMPLE.
AND FIVE MINUTES LATER IN THE
MACHINE, WELL, BOTH GROUPS,
YOUNGER, YOU KNOW, THE 18 YEAR
OLDS AND THE 70 YEAR OLDS DID
EXACTLY THE SAME.
THEY DID VERY WELL.
BUT YOU KNOW, WITHIN, SO THEY
GOT THE SAME RESULTS.
EXCEPT WHEN YOU LOOK IN THE
BRAIN.
WOW, THE INFORMATION WAS
PROCESSED VERY, VERY
DIFFERENTLY.
SO YES, COGNITIVE FUNCTIONS AND
MEMORY CHANGES WITH, WITH
AGING.
IT'S PREJUDICED TO SAY THAT YOU
KNOW, IT DETERIORATES.
RIGHT?
THINGS CHANGE, IT'S DIFFERENT.
SO, INFORMATION IS PROCESSED
VERY DIFFERENTLY AS WE MATURE.
THANK GOD, OKAY, I THINK.
AND SO THIS IS A YOUNG BRAIN,
AND YOU SEE HOW THINGS ARE VERY
DIFFERENT IN THE 18 BRAIN.
SO, WHAT IS IT WITH NORMAL
AGING THAT CHANGED?
WELL, THE WORST THAT HAPPENS,
WITH THE, THE MAJOR CHANGE IS
REALLY WITH RECENT, RECENT,
RECENT MEMORY.
RECENT MEMORY.
OKAY?
AND RECENT MEMORY IS LIKE WHAT
YOU REMEMBER LIKE WITHIN AN
HOUR TO A FEW DAYS.
OKAY?
THAT'S HOW IT'S MEASURED.
AND THIS SPONTANEOUS RECALL,
LIKE FROM MY MIND, OKAY, IF I
LEARNED SOMETHING, THAT LEARNED
THE BATH, AND TO GET THAT STUFF
OUT OF THERE IS REALLY, IS, IS
THE WORST PROBLEM THAT WE
NOTICE WITH, THAT PEOPLE
COMPLAIN ABOUT.
AND HOW WE TEST THAT IS WE GIVE
SHOPPING LISTS TO PEOPLE, 16
WORDS IN THIS CASE, AND WE
REPEAT THEM FOUR TIMES.
AND 20 MINUTES LATER WE ASK
THEM DO YOU REMEMBER THAT LIST
WE GAVE YOU?
OKAY, DO YOU REMEMBER THAT LIST
WE GAVE YOU?
AND THEY HAVE TO GIVE IT
SPONTANEOUSLY FROM, FREELY FROM
THEIR MIND WITHOUT HAVING ANY
CUES AROUND THEM.
SO, YOU GIVE THOSE LISTS AND
YOU KNOW, PEOPLE CAN ACTUALLY
CHUNK THEM AS YOU MOVE ALONG
INTO SPICES AND HERBS AND
FRUITS AND, AND VEGETABLES, AND
MILK PRODUCTS.
SO, THEY CAN ACTUALLY CHUNK
INFORMATION.
YOUNG PEOPLE DO VERY, VERY WELL
AND AS YOU AGE, AS YOU AGE,
OKAY, 75 AND OVER, YOU GET
ABOUT HALF OF THAT LIST.
SO, THAT'S THE WORST PROBLEM WE
SEE WITH NORMAL AGING.
FREE RECALL FROM THE MIND.
NOW, INTERESTING THING THOUGH,
WE CAN COMPENSATE FOR THAT.
WE CAN COMPENSATE.
WHAT WE DO HERE IS THAT, THAT
LIST THAT THEY'VE LEARNED,
THOSE 16 WORDS, AND WHAT WE DO
IS NOW WE EMBED THOSE IN 60
FOILS.
AND LO AND BEHOLD, WHEN WE ASK
PEOPLE TO RECOGNIZE, NOT TO
RECALL FREELY, BUT TO RECOGNIZE
THE ONES THAT THEY'VE LEARNED
FROM ALL OF THESE FOILS, THE
75, 80 YEAR OLD, YOU KNOW, DO
VERY, VERY WELL.
SO, YOU KNOW, ENVIRONMENT
SUPPORT.
WHEN YOU CAN RECOGNIZE WHAT
YOU'VE LEARNED THEY'RE ABLE TO
PICK THAT OUT.
SO, THOSE, THERE ARE PROBLEMS,
BUT WE CAN COMPENSATE FOR THEM.
THE QUESTION WILL BE THEN CAN
WE ALSO COMPENSATE IN THE
BRAIN?
DOES THAT, DOES THAT REFLECT
COMPENSATION ALSO IN THE BRAIN?
NOW, THERE ARE PROBLEMS, BUT
YOU KNOW, SOME OF THE MYTH
ABOUT AGING ARE, ARE ALL BEING
SHOT DOWN.
ONE OF IT IS FOR EXAMPLE, ONE
THING THEY JUST DID, SOMETIMES
ACTUALLY NO CHANGE, IMPROVES
SOMETIMES WITH AGING IS FACTS,
KNOWLEDGE, VOCABULARY.
THE AVERAGE AGE OF CANADIAN
JUDGES, AMERICAN JUDGES IS WAY
UP THERE IN, IN THEIR EARLY
70S, LATE 60S.
WHY?
BECAUSE THEY HAVE MORE
KNOWLEDGE, MORE EXPERIENCE, OR
WHAT SOME PEOPLE REFER TO AS
MORE WISDOM.
OKAY?
THE IMMEDIATE MEMORY, THIS IS
SURPRISING.
OKAY?
WHAT IS IMMEDIATE MEMORY?

He continues to run slides that show what he mentions.

He says IMMEDIATE MEMORY IS THE ABILITY
TO REMEMBER SMALL AMOUNTS OF
INFORMATION OVER A FEW SECONDS.
HOW DO WE MEASURE THAT?
WE GIVE THEM LISTS OF, OF
NUMBERS INCREASING.
OKAY?
AND THE AVERAGE PERSON GIVES
YOU ABOUT SEVEN, THE MAGICAL
SEVEN PLUS OR MINUS TWO.
OKAY?
SO, WE CAN TAKE ABOUT SEVEN
BITS OF INFORMATION
IMMEDIATELY, PLUS OR MINUS THAT
IN TWO.
OKAY, WHAT HAPPENS WITH THE
ELDERLY?
LOOK AT THIS, VERY LITTLE
CHANGE.
SO, YOU CAN DRIVE YOUR CAR FROM
TORONTO HERE AT 85 TO MONTREAL.
YOU CAN SUSTAIN IMMEDIATE
MEMORY.
SO YOU KNOW, IT, IT REALLY
MAINTAINS VERY WELL.
SO, THIS TO SHOW YOU, THE
ANSWER TO THINGS THAT CHANGE,
YOU CAN COMPENSATE FOR THOSE IN
NORMAL AGING.
AND SOME DON'T, ACTUALLY SOME
SEEM TO, SOME DO ACTUALLY
IMPROVE.
OKAY?
AND NOW, MORE THINGS THAT ARE
MORE LIKE COMPARE WITH NORMAL
AND NOT.
WHAT'S NORMAL, WHAT'S NOT?
WELL, FORGETTING THE NAME OF
SOMEONE YOU'VE ONLY SEEN, YOU
SEE NOW AND THEN, FORGETTING MY
NAME TOMORROW.
THAT'S NORMAL.
OKAY?
WHAT'S NOT NORMAL IS FORGETTING
THE NAME OF A CLOSE FAMILY.
YOU KNOW, IF YOU CAN'T REMEMBER
THE NAMES OF YOUR CHILDREN, AND
YOUR WIFE, THERE'S A PROBLEM.
OKAY?
AND THAT'S THE WAY IT IS.
OKAY?
SO, PEOPLE HAVE FUNNY IDEAS
ABOUT WHAT'S NOT NORMAL.
WHAT'S NORMAL?
WELL, FORGETTING TO BUY
SOMETHING AT THE STORE.
THAT'S, THAT'S NORMAL.
OKAY?
FORGETTING THAT YOU'VE BEEN TO
THE STORE AN HOUR AGO, NOW,
THAT'S NOT NORMAL.

[Audience laughs]

Guy continues OKAY?
WHAT'S NORMAL?
REPEATING A COMMENT OR A
QUESTION A FEW HOURS LATER.
A LOT OF US DO THAT.
OKAY?
WHAT'S NOT NORMAL IS REPEATING,
REPEATING A COMMENT AND A
QUESTION SECONDS LATER.
OKAY?
SO, BELIEVE ME, WHEN THERE ARE
PROBLEMS, THERE'S DISEASE, IT'S
VERY, IT'S, IT'S MUCH MORE
OBVIOUS THAN PEOPLE THINK.
OKAY, NOW, NOW, WE'RE JUMPING
INTO THE DISEASE PROCESS.
WE HAD A LOOK AT A BIT OF
NORMAL AGING.
DISEASE PROCESS, ALZHEIMER'S
DISEASE, OKAY, WHICH IS A BIG
ONE, 50 percent AT LEAST IF NOT MORE.
AND WHAT YOU HAVE, WHAT HAPPENS
WITH ALZHEIMER'S IS YOU GET
THIS TOXIC ACCUMULATION OF A
PROTEIN.
SO, PROTEIN GO IN THERE AND
THEY'RE YOU KNOW, THEY GO THERE
WHEN THERE'S DAMAGE, THERE'S
SOME NEED TO, TO BUILD BODY
PARTS.
RIGHT?
FROM HAIR TO DERRIERES.
RIGHT?
YOU NEED PROTEINS.
RIGHT?
AND SO YOU KNOW, YOU GET THIS
ACCUMU...
YOU GET THOSE, THOSE PROTEINS,
BUT FOR SOME REASON, WELL, ONE
REASON THAT THEY, THEY KNOW IS,
IS THAT THERE'S A CHROMOSOME
19, FOR EXAMPLE, DOES NOT
PRODUCE A, A CHOLESTEROL
BREAKING AGENT.
SO, THEY CAN'T BREAK, BREAK
DOWN THE ACCUMULATION OF THIS,
OF THIS PROTEIN.
IT BECOMES TOXIC AND WHEN IT
DOES IT KILLS THOSE NEURONS OUT
THERE.
AND SOME OF THE DRUGS THAT
PEOPLE ARE TRYING, TO DEVELOP,
ARE DEVELOPED, IS TO BREAK OUT,
TO BREAK THIS AGGREGATION OR
THE ACCUMULATION OF THIS
PROTEIN.
OTHER DRUGS TO REDUCE...
YOU SEE THE INFLAMMATION, HOW
RED IT IS?

He uses the laser pointer to point at a slide that displays neuronal connections.

He continues WELL, JUST LIKE ARTHRITIS, YOU
MAY HAVE A LOT OF ARTHRITIS AND
YOU CAN'T MOVE.
YOU GET ANTI-INFLAMMATORIES,
YOU MOVE MUCH BETTER.
YOU HAVEN'T DONE ANYTHING TO
THE DISEASE.
THE DISEASE CONTINUES, BUT
FUNCTIONALLY YOU DO MUCH, MUCH
BETTER.
AND THIS IS ONE AREA WHERE THEY
HOPE WITH ANTI-INFLAMMATORIES
MAYBE, THAT SOME DRUGS WHERE
YOU CAN REDUCE THIS, YOU GET
BETTER SYMPTOMS.
BUT IT DOES NOTHING TO THE
PROGRESSION OF THE DISEASE.
OKAY?
NOW, SO THIS IS A, THIS IS AN
EXAMPLE, WHAT HAPPENS WITH
ALZHEIMER'S HERE, YOU GO INSIDE
THE TEMPORAL REGIONS, SOMETHING
TERRIBLY STARTS HAPPENING YOU
KNOW, IN THIS AREA.
REMEMBER THIS NAME.
WE'LL COME BACK TO IT.
THE BASIL FOREBRAIN NUCLEI
WHICH PRODUCES A NEURO-
TRANSMITTER CALLED
ACETYLCHOLINE.
OKAY?
CHOLINERGIC, NEURO-
TRANSMITTERS.
OKAY?
AND THEN THERE'S, NOW THIS AREA
HERE GOES TERRIBLY WRONG AND IT
PROJECTS INTO THE HIPPOCAMPUS.
WHAT DOES THE HIPPOCAMPUS DO?

A slide shows the human brain.

Guy continues THAT'S THE PART OF THE BRAIN
THAT LAYS DOWN NEW MEMORIES.
ANYTHING YOU LEARN NEW, OKAY,
HAS TO GO THROUGH THIS MACHINE
HERE.
OKAY?
THE HIPPOCAMPUS.
SO, THERE'S DAMAGE OVER HERE,
AND THEN YOU KNOW, WITH, THEN,
THESE, THESE, THESE, THE
CHOLINERGIC NEURO-TRANSMITTERS
PROJECT TO THOSE TEMPORAL
REGIONS, FRONTAL.
SO, ALL THESE RED DOTS HERE ARE
THOSE ACCUMULATION OF THOSE
PLAX, OF THOSE, OF THOSE OF
THOSE AMYLOID PLAX THAT KILL
THE NEURONS.
SO, BASICALLY, THE FRONTAL
AREAS, TEMPORAL, PORIDIERIES.
BUT NONE HERE AT THE PRIMARY
MOTOR, PRIMARY SENSORY AREAS,
PRIMARY VISUAL AREAS.
SO ALZHEIMER'S DISEASE,
TYPICALLY WHEN YOU SEE THEM
THEY LOOK VERY GOOD.
OKAY?
IN TERMS OF MOTOR, THEY DON'T
HAVE ANY PHYSICAL PROBLEMS,
THEY USED TO SAY.
YOU START TALKING TO THEM.
WOW, I MEAN THEY HAVE BIG
PROBLEMS.
WELL, THAT'S BECAUSE THEY HAVE
DAMAGE TO A VERY IMPORTANT
PHYSICAL PART OF THE BRAIN, OF
THE, OF THE HUMAN BODY WHICH IS
THE HUMAN BRAIN.
SO, THEY DON'T HAVE DAMAGE IN
THE SUB-CRITICAL REGIONS OR IN
THE PRIMARY MOTOR.
THEY DO WELL, UNTIL VERY LATE
IN THE DISEASE.
PARKINSON'S DISEASE WHICH OFTEN
CAUSES DEMENTIA ALSO EFFECTS
YOU KNOW, THE BASIL GANGLY AREA
OF THE BRAIN, AND THEY HAVE
DAMAGE BELOW.
SO, THE FIRST THING YOU'D SEE
IN A PATIENT WHO HAS
PARKINSON'S IS SLOWNESS AND
MOTOR PROBLEMS.
NOT ONLY SLOWNESS IN THE MOTOR
FUNCTIONS, BUT ALSO WITH MEMORY
FUNCTIONS AND EVEN COGNITIVE
FUNCTIONS.
OKAY?
NOW, VASCULAR DEMENTIAS.
IF YOU TOOK THE BRAIN, AND YOU
TOOK ALL THE BRAIN TISSUE AND
ALL YOU WERE LEFT WITH WOULD BE
THE VASCULAR TUBING.
OKAY?
THE BLOOD SUPPLY TO THE BRAIN.
YOU KNOW, SO YOU'D HAVE THOSE
BIG ARTERIES, AND YOU'D HAVE
ALL THESE TINY BLOOD VESICLES,
AND LITTLE, TINY CAPILLARIES, A
LOT OF THINGS COULD GO WRONG.
PEOPLE ARE VERY NAIEVE ABOUT
THAT.
SO, VASCULAR DEMENTIA IS A BIG
ONE OUT THERE, AND WE'LL BE
HEARING A LOT MORE AND THEN YOU
KNOW ABOUT THAT.
WE'RE HEARING, WE KNOW QUITE A
BIT, WHEN YOU KNOW, WE TALK
ABOUT MULTIPLE...
DEMENTIAS, BUT THAT'S JUST ONE
PART, ONE ASPECT OF VASCULAR
DEMENTIA.
IF YOU TOOK ALL THE TUBING IN
THE HUMAN, IN ONE BODY, OKAY,
ALL THE VASCULAR TUBING AND
TIED ONE BESIDE THE OTHER, YOU
COULD WRAP IT AROUND THE EARTH
TWO TIMES.
A LOT OF THINGS COULD GO WRONG
WITH THIS.
OKAY?
SO, WE'RE NOT PAYING ENOUGH
ATTENTION TO THAT AND MUCH
RESEARCH IS BEING DONE IN THIS
FIELD.
OKAY?
SO, NOW WE LOOK AT THE BRAIN
NORMAL AGING, WE LOOK AT
DEMENTIA A LITTLE BIT.
LET'S LOOK AT THE BEHAVIOUR
WHEN SOMEBODY HAS DEMENTIA.
OKAY?
SO, BIG, A NICE TIP FOR YOU, A
NICE TIP, TO UNDERSTAND ABOUT
DEMENTIA, BECAUSE DEMENTIA
AFFECTS THE ASSOCIATION AREAS
OF THE BRAIN.
THE THINKING, COGNITION,
MEMORY.
THINK OF THE FOUR A'S, I'LL BE
TEACHING YOU ABOUT THE FOUR A'S
AND E.
OKAY?
BREAK DOWN IN LANGUAGE,
APHASIA.
BREAK DOWN IN MOTOR, COMPLEX
MOTOR, PURPOSEFUL MOVEMENT,
APRAXIA.
BREAK DOWN IN PERCEPTION,
AGNOSIA.
BREAK DOWN IN MEMORY, AMNESIA.
BREAK DOWN IN EXECUTIVE
FUNCTION OR PLANNING AND
COMPLEX SEQUENCE OF BEHAVIOUR,
AN EXECUTION OF BEHAVIOUR,
EXECUTIVE FUNCTIONS.
SO, LET'S LOOK AT THOSE AND
REMEMBER THAT THOSE COMPLEX
BEHAVIOURS ARE RELATED TO
DAMAGE TO THE BRAIN.
SO, THEY'RE JUST NOT
BEHAVIOURS, DISCONNECTED OR
DISEMBODIED.
OKAY?
SO, THE FIRST ONE IS APHASIA,
BREAK DOWN IN LANGUAGE.
THE PATIENT COMES TO MY OFFICE
AND I DO THIS SIMPLE TEST.
OKAY?
I, I, I HAVE A PEN, I HAVE A
PENCIL, AND I SAY, GOOD
MORNING, MR. JONES.
NOT A PROBLEM, GOOD MORNING.
TOUCH, I, I HAVE THIS TEST FOR
YOU.
I HATE TESTS.
WELL, YOU KNOW, THEY'RE USUALLY
AWARE.
YOU ASK THEM, DO YOU THINK YOU
HAVE A MEMORY...
WELL, OF COURSE I DO.
I'M A MEMORY SPECIALIST.
OKAY, I'LL DO A TEST.
I SAY, WELL, TOUCH THE PENCIL
WITH THE PEN, AND MR. JONES
TYPICALLY LOOKS AT, WOULD
TYPICALLY LOOK AT ME BEWILDERED
AND CONFUSED.
I AM A SCIENTIST OF HUMAN
BEHAVIOUR.
SO, I WRITE DOWN, MR. JONES,
APPEARS BEWILDERED, COMMA,
CONFUSED, QUESTION MARK.

[Audience laughs]

Guy continues SO, THEN MR.
JONES DOESN'T DO IT.
HE LOOKS PERPLEXED.
SO, WHAT I DO, MR. JONES, WHAT?
HE'S 75, WHITE HAIR, I SHOUT,
MR. JONES, TOUCH THE PENCIL
WITH PEN!
HE, OOH...

[Audience laughs]

Guy continues THE HEARING IS
PERFECT.
YOU KNOW, BUT, SO, SO, YOU
KNOW, AND THEN MR. JONES,
BECAUSE YOU'RE INSISTING,
BECAUSE YOU'RE INSISTING.
RIGHT?
HE TOUCHES THE PEN AND THE
PENCIL.
TALK ABOUT WIT.
I ASK HIM TO DO A SIMPLE TEST,
TOUCH THE PENCIL WITH THE PEN.
HE COULDN'T DO THAT.
EY, THE SCIENTIST OF HUMAN
BEHAVIOUR SAYS, HE DOES NOT
ONLY LOOK CONFUSED, HE IS.

[Audience laughs]

Guy continues OKAY?
THE PROOF.
NOW, THE BREAK DOWN IN LANGUAGE
IN THIS CASE, YOU KNOW, WHEN
YOU UNDERSTAND THE BRAIN AND
HOW IT WORKS, THE BRAIN, IN
THIS, ASSOCIATION AREAS AND
TEMPORAL REGIONS OF THE BRAIN,
WHAT BREAKS DOWN IS, THEY HAVE
MOST, MANY OTHER PROBLEMS.
ONE OF THEM IS CALLED IG,
THEY'RE IGRO, IGROMATIC, THEY
HAVE AGRAMMATISM.
SO, THAT MEANS, THAT MEANS, IF
WE DO THIS TEST AGAIN, THAT
MEANS IF YOU LOOK AT ALL THE,
THE SENTENCE, TOUCH THE PENCIL
WITH THE PEN, THEY HEARD EVERY
SINGLE WORD IF YOU MEASURE THE
END OF THE AUDITORY SYSTEM.
THEY HEARD EVERYTHING.
BUT THE ONLY WORDS THAT THEY
COULD COMPREHEND, OR MAKE
ASSOCIATIONS WITH WERE THE
SUBSTANTIALS.
PEN, PENCIL, THE, WITH, THE.
THE RELATION BETWEEN THE WORDS
WHICH IS GRAMMAR, IF YOU DIDN'T
KNOW THAT.
OKAY?
NEVER THOUGHT YOU'D NEED YOUR
GRAMMAR, EY?
SO, THE WITH THE IS WHAT THEY
HEAR, BUT THEY JUST CAN'T MAKE
THE ASSOCIATIONS.
SO, BASICALLY MR. JONES, ALL
ALONG WHEN I ASKED HIM TO DO
THAT WHAT HE UNDERSTOOD, WAS
TOUCH, MR. JONES, THAT'S FINE.
NO GRAMMAR THERE.
TOUCH PENCIL BEEP, BEEP PEN.
MR. JONES, TOUCH PENCIL BEEP,
BEEP PEN.
AND BECAUSE I WAS INSISTING
WITH MY FACE, MY VOICE, THIS IS
OTHER PARTS OF THE BRAIN.
THE RIGHT BRAIN MODULATES
EMOTIONS.
MY VOICE, WELL, MY LUNGS
MODULATE THAT.
MY HANDS, WELL, OKAY.
SO, HE CAN SEE, HE COULD, I WAS
INSISTING, SO POOR, MR. JONES
WENT AHEAD AND TOUCHED PENCIL,
PEN, BECAUSE THAT'S WHAT HE
UNDERSTOOD.
TOUCH PENCIL, PEN, AND THERE
WAS SOMETHING MISSING THERE.
NOW, HE WAS CONFUSED SAYS THE
SCIENTIST OF HUMAN BEHAVIOUR.
RIGHT?
RIGHT?
NOW WE KNOW BETTER.
HE'S GOT YOU KNOW, THIS
LANGUAGE APHASIA FIRST DAY.
THIS APHASIA PROBLEM.
LET'S DO IT AGAIN, BUT NOW
UNDERSTANDING WHAT'S GOING IN,
ON.
OKAY?
GOOD MORNING, THERE'S NO
PROBLEM.
TAKE THE PEN.
MR. JONES TAKES THE PEN EVERY
TIME.
MR. JONES, TOUCH THE PENCIL.
AH, THE PATIENT WAS CONFUSED.
HE'S NO LONGER CONFUSED.
WHY?
BECAUSE THERE ARE MORE
CONFUSIONS WITH DOCTORS, AND
MORE CONFUSIONS WITH FAMILIES,
AND MORE CONFUSIONS BECAUSE OF
WHAT WE DON'T UNDERSTAND, THEN
OUR CONFUSED PATIENTS.
IT'S, WE HAVE THE CONFUSION.
THE STRESS IS ON US.
WE HAVE TO FIND THE ANSWERS,
BEFORE WE PUT THE STIGMA ON
OTHER PEOPLE.
OKAY?
SO, THAT'S THE FIRST A.
SECOND A IS APRAXIA.
APRAXIA IS THE INABILITY TO
TRANSDUCE A VERBAL COMMAND INTO
ITS MOTOR EXPRESSION.
SOUNDS SIMPLE TO YOU, EY?
IF I WOULD ASK YOU PEOPLE A
VERY SIMPLE QUESTION, RAISE
YOUR RIGHT HAND.
RIGHT?
WELL, THAT'S EASY.
RIGHT?
IS IT NOT EASY?
RAISE YOUR RIGHT HAND.
THERE WE ARE.
OKAY.
SO NOW, WE TAKE THIS FOR
GRANTED.
IF YOU HAVE ALZHEIMER'S
DISEASE, WHICH QUITE A FEW
PEOPLE MIGHT HERE.

[Audience laughs]

Guy continues AH, NOBODY RAISE
THEIR HAND.
YOU KNOW, YOU HAD TO TAKE
SOUNDS AND THOSE SOUNDS HAD TO
BE GIVEN INTO ENGLISH.
AH?
SO, YOU HAVE TO TAKE THOSE
SOUNDS, TAKE, RAISE YOUR RIGHT
HAND, TAKE THOSE SOUNDS, MAKE
THE ASSOCIATIONS IN THE
AUDITORY AND, AND VERBAL
SECTIONS OF THE BRAIN, AND THEN
TRANSMUTE THAT, PUSH THAT OVER
TO THE MOTOR SYSTEM.
IT'S MUCH MORE COMPLICATED THAN
WE, WE THINK.
AND THAT'S WHAT BREAKS DOWN
WITH DEMENTIA, ALZHEIMER'S
DISEASE.
SO, YOU TELL A PATIENT FOR
EXAMPLE, HERE I SAY TO HIM,
SMILE FOR ME.
SO, THIS MAN HERE HAD A SERIES
OF, OF SMALL STROKES, VASCULAR
DEMENTIA ON THE, ON THE LEFT
SIDE OF THE BRAIN.
OKAY?
AND I, SO HE HAD SOME LANGUAGE
PROBLEM, AND THEN I ASKED HIM
TO SMILE WITH WORDS.
SMILE FOR ME, AND THIS IS WHAT
HE DID.
YOU CAN SEE HE'S PARALYZED ON
THIS SIDE.
RIGHT?
BECAUSE THAT, THE LEFT SIDE
CONTROLS THE RIGHT SIDE OF THE
BRAIN.
THEN, I SAID, I, I SAID, NO,
LIKE THIS...

He grins widely and says
SO, IMITATION.
BUT HE DOES A LITTLE BIT
BETTER.
BUT IT'S NOT VERY GOOD.
OKAY?
AND THEN THE LAST SLIDE, WHAT I
DID, IS THAT I SHOWED HIM
SOMETHING VERY FUNNY, MY COMB
HAS BEEN WITH ME FOR MANY, MANY
YEARS.
IT'S A GERIATRIC COMB, TWO
TEETH MISSING.
I HAD A LOT OF HAIR, GUYS.
SO, AND I, I SHOWED HIM MY
COMB.
AH!
YOU KNOW, THIS IS AMAZING.
THE PARA, THE PARALYSIS IS
GONE.
WHY?
WELL, WE KNOW WHY.
WHY?
BECAUSE THERE ARE TWO ROOTS IN
THE BRAIN FOR THE SMILE.
THERE'S A, THERE'S AN INDIRECT,
OKAY, SMILE, THE VOLUNTARY
SMILE.
SO, WHEN I ASKED HIM TO SMILE
WITH WORDS, IT HAD TO GO TO THE
CORTEX, OKAY, AUDITORY CORTEX,
MAKE THE ASSOCIATION, GO DOWN
TO THE MUSCLES OF THE SMILE AND
EXECUTE THAT.
BUT HE WAS DAMAGED, SO HE
COULDN'T DO THAT.

A slide shows the process of smiling.

He continues THAT'S DAMAGE.
THEN WHEN I SHOWED HIM
SOMETHING VERY FUNNY, IT WENT
INTO THE PRIMITIVE BRAIN, THE
EMOTIONAL BRAIN, NO DAMAGE
THERE.
IT WENT RIGHT TO THE GUT.
TO THE EMOTIONAL BRAIN AND
BINGO, THE PARALYSIS WAS GONE.
OKAY?
ANOTHER CONFUSED PATIENT,
ANOTHER SMALL MIRACLE, BECAUSE
WE UNDERSTAND THE COMPLEXITIES
OF THIS.
THIS IS BEAUTIFUL I THINK.
EY?
SO NOW, ACKNOWLEDGE YOUR
PERCEPTUAL PROBLEM.
LISTEN, LOOK AT THIS.

A slide under the title "Knowledge without awareness" appears on screen. It reads "Steps of the process of recognition still take place despite an inability to experience familiarity and formal recognition. Patients with severe amnesia can still learn complex skills."

He continues STEPS IN THE PROCESS OF
RECOGNITION STILL TAKE PLACE
DESPITE THE INABILITY TO
EXPERIENCE FAMILIARITY AND
FORMAL RECOGNITION.
THIS MEANS THAT PUTTING A NAME
ON SOMEBODY'S FACE IS JUST ONE
TINY, TINY PART TO RECOGNITION.
SO, THE WAY WE MEASURE THAT,
RESEARCH, MEASURE THAT, WAS
THAT THEY WOULD HOOK PEOPLE ON
ANOTHER PART OF THE, THE
NERVOUS SYSTEM.
SO, THE ONE WE'RE TALKING ABOUT
HERE IS THE CENTRAL NERVOUS
SYSTEM.
THE BRAIN AND THE SPINAL CORD,
AND BEYOND THAT, ALL THE NERVES
GOING OUTSIDE, IT'S CALLED THE
PERIPHERAL NERVOUS SYSTEM.
AND IN THE GUTS.
OKAY?
AND IN THE ORGANS.
THAT'S CALLED THE -û NERVOUS
SYSTEM.
YOU CAN MEASURE THAT WITH A
MACHINE CALLED, THEY CALL IT,
IT'S GALVANIC SKID RESPONSE.
SOME PEOPLE CALL IT LIE
DETECTOR.
IT'S THE WRONG WORD.
YOU GET 13 PEOPLE, THEY'RE
MOSTLY STRANGERS, THREE OF
WHICH ARE THE WIFE AND THE
DAUGHTERS.
AND THE, AND THE PERSON WITH
ALZHEIMER'S, WITH THIS, WITH
THIS PROBLEM, WOULD SAY HELLO
TO ALL THESE PEOPLE, NOT
RECOGNIZING THE THREE, THE TWO
DAUGHTERS AND THE SPOUSE.
AND THAT'S VERY DIFFICULT ON
THE FAMILY.
WE'VE BEEN MARRIED FOR 50
YEARS.
HE DOESN'T RECOGNIZE ME.
IT'S VERY HARD.
OKAY?
ON THEM.
OKAY?
THEN YOU HOOK HIM ON THIS
MACHINE, LO AND BEHOLD, HE SAYS
HELLO TO EVERYBODY, BUT ONLY
THE RESPONSE OF THE, OF THE,
THE ONLY RESPONSE TO THE LOVED
ONES, TO THE DAUGHTERS AND TO
THE WIFE.
SO YOU KNOW, BEFORE YOU GO TO
VISIT SOMEBODY WHO'S GOT A LOT
OF DAMAGE, AND YOU SAY THEY
DON'T RECOGNIZE ME, BE VERY
CAREFUL.
BECAUSE RECOGNITION IS A
COMPLEX PROCESS AND MANY, MANY
ASPECTS STAY TO THE LAST
BREATH, OKAY, TO THE LAST
SECOND.
THE OTHER "A," AMNESIA.
THE LAST "A," IS PATIENTS WITH
SEVERE AMNESIA CAN STILL LEARN
COMPLEX SKILLS.
OKAY?
OOH, I'M DOING GOOD.
OKAY, IT'S, MY TIME IS FINE.
EY?

says YEAH, YOU'RE DOING...

Guy says I'M ON A, HEH,
OH.

[Audience laughing]

Guy continues OKAY, IS THAT
WATER FOR ME?

says YEAH.

Guy says OKAY, GOOD,
THANK YOU.
NOW, SO THE LAST THING, THE
LAST THING, AMNESIA.
A PATIENT WITH SEVERE AMNESIA,
NOW THESE DISCOVERIES I'LL BE
TALKING TO YOU ABOUT NOW, I
GOTTA TELL YOU, U OF T, WE'RE
HOT, WE'RE GOOD.
NOT ME, I KNOW SOME OF MY
COLLEAGUES.
I WORK WITH DR. TOLLING, DR.
MOSCOVITZ, DR. CRAIG.
UNBELIEVABLE, OKAY, THE GIFTS
THAT UNIVERSITY OF TORONTO AND
BAYCREST, AND RESEARCH ARE
GIVING TO THE WORLD.
OKAY?
IN THIS FIELD.
NOW, WHAT THEY FOUND, OKAY, IS
THAT ALTHOUGH YOU CAN'T
REMEMBER, YOU CAN'T REMEMBER,
THAT'S HOW BAD THE MEMORY COULD
BE, YOU COULD STILL LEARN SOME
THINGS.
OKAY?
SO AH, SO AH, THIS IS A PATIENT
WE SAW, I SAW AT BAYCREST A
WHILE BACK.
IT WAS SO BAD, THIS GUY WAS
WALKING AROUND WITH THIS
DRAWER.

A slide shows a drawer with inscriptions written on the back.

He continues AND IN THIS DRAWER HE HAD
LITTLE...
OH, I HAD A STROKE IN A PART OF
THE BRAIN THAT HELPS TO LAY
DOWN NEW MEMORIES.
AND DON'T WORRY ABOUT GOING
BACK TO WORK BECAUSE IT'S BEEN
TAKEN CARE OF BY THE SOCIAL
WORKER AND YOUR, AND MY WIFE,
OKAY, SO ON AND SO FORTH.
AND HE WOULD MEET WITH YOU AND
HE WOULD SAY, HELLO.
WHAT'S YOUR NAME?
CAN I GO HOME?
CAN I GO BACK TO WORK?
NO, YOU HAD DAMAGE, YOU KNOW.
THANK YOU, VERY NICE, HE'D WALK
OVER HERE.
HELLO.
WHAT'S YOUR NAME?
WHY AM I HERE?
NOT EVEN A MINUTE, HE'S
STARTING ALL OVER AGAIN.
YOU DO THIS THREE, 400 TIMES IN
HALF A DAY THOSE NURSES ARE
GOING LIKE, REALLY NERVOUS.
AND THEY GET NERVOUS.
HE GETS NERVOUS.
AND FIRST THING YOU KNOW
SOMETIMES YOU KNOW, YOU HAVE TO
MANAGE THIS THROUGH MEDICATION,
CAUSE IT'S VERY, VERY, VERY, IT
WAS VERY COMPLEX A MINUTE AGO.
I CHECKED THE FILES, AND I SAW,
HE HAD A VERY ENGLISH NAME, AND
I SAW IN THE FILES THAT HE WENT
TO A FRENCH SCHOOL IN QUEBEC
CITY.
MY BROTHER AT THE SAME AGE WENT
TO THAT SAME SCHOOL.
UH?
SO, I MEET WITH HIM.
HE SAYS, GOOD MORNING.
WHO ARE YOU?
CAN I GO HOME?
CAN I GO BACK TO WORK?
NO, YOU HAVE A...
THEN I SAID, PARLEZ VOUS
FRANCAIS?
HE SAID, OUI.
YOU KNOW, AND I TELL YOU, WELL
HE SAYS IT IN FRENCH.
HE SAYS, WELL, I, MY, MY FATHER
WAS IN THE ARMY, WENT TO...
NOT TOO FAR FROM QUEBEC, SENT
ME TO THIS FRENCH SCHOOL
BECAUSE HE THOUGHT THAT
BILINGUALISM WOULD PAY ONE DAY.
RIGHT?
AND HE HAPPENED TO FIND A JOB
THAT IT WAS VERY USEFUL TO BE
BILINGUAL.
SO ANYWAY, WE'RE TALKING
FRENCH.
AND HE SAYS, WHO ARE YOU?
WHY AM I HERE?
WHEN CAN I GO BACK TO WORK?
SO, HE HAD NOT REGISTERED IT AT
ALL.
OKAY?
THE NEXT DAY WE'RE DOING
ROUNDS.
AND GUESS WHAT?
WE'RE ABOUT YOU KNOW, FIVE OR
SIX DOCTORS, WE'RE DOING ROUNDS
AND WHAT HE SAYS, HE SAYS TO ME
IN FRENCH, WHO ARE YOU?

[Speaks French]

He says WHY AM I HERE?

[Speaking French]

He says CAN I GO HOME?
I SAY TO HIM, WHY DO YOU DO
TALK FRENCH TO ME AND NOT TO
THEM?
HE HAD NO IDEA.
WE INSIST, BECAUSE IT WAS THE
FIRST TIME I SAW THAT.
WHY ARE YOU TALKING FRENCH TO
ME?
HE SAYS, ARE WE GETTING
POLITICAL HERE?

[Audience laughing]

Guy continues YOU KNOW,
BECAUSE HE LOOKED STUPID.
YOU KNOW, I MEAN HE WAS RUDE.
AH?
SO, HE LOOK CONFUSED.
I GOT HIM INTO MY OFFICE, OKAY,
HE COMES TO MY OFFICE HE SAYS,
YOU KNOW, WHO ARE YOU?
HELLO.
CAN I GO HOME?
CAN I GO BACK TO...
NO.
AH, IT'S NOT EASY.
OKAY?
THEN I SAID I HAVE A TEST FOR
YOU.
SO, HE SAYS, THIS IS THE TYPE
OF TEST, A MOTOR TEST, YOU DO
ONCE, TWICE, THREE TIMES, YOU
GET BETTER AND BETTER AND
BETTER.
HE DOES IT ONCE.
I TIME HIM.
OKAY?
AND HE DOES RIGHT IN THE
AVERAGE.
HE DOES VERY WELL.
I GUESS THERE'S NO MOTOR
PROBLEM WITH THIS GUY.
I SAY WOULD YOU LIKE TO HAVE A
COFFEE?
HE SAYS, YES.
WHAT DO YOU TAKE?
MILK AND SUGAR.
I GO BACK, TAKE THE MILK AND
SUGAR.
I COME BACK, HE SAYS, WHO ARE
YOU?
WHY AM I HERE?
CAN I GO BACK HOME?
CAN I GO BACK HOME?
I SAID, NO.
AND IF I WOULD'VE SAID HERE'S
YOUR COFFEE, HE WOULD HAVE JUST
GOT REALLY UPSET.
I NEVER ASKED YOU FOR A CUP.
I SAYS, HERE'S A COFFEE.
HE TAKES A COFFEE.
HOW DO YOU KNOW I TAKE MILK AND
SUGAR?
I GO, I DIDN'T LIE.

[Audience laughs]

Guy continues SO, HE WENT, SO
YOU KNOW, I SAID, YOU KNOW,
THAT TEST?
I COULDN'T SAY TO HIM, LET'S DO
IT AGAIN.
WELL, YOU KNOW WHAT?
HE SAID WHO ARE YOU?
WHY AM I HERE?
CAN I GO BACK...
YOU KNOW, SO HEY, HE HAD NO
IDEA.
HE DOES IT THE SECOND TIME, HE
GETS BETTER AND BETTER.
HE COULDN'T REMEMBER, HE
COULDN'T REMEMBER MY FACE,
VISUAL MEMORY.
HE COULDN'T REMEMBER MY NAME,
VERBAL MEMORY.
HE COULDN'T, NONE OF THAT
STUFF.
BUT YOU'D HAVE HIM DO A TASK.
SO, YOU KNOW, THIS IS VERY,
VERY GOOD KNOWLEDGE.
WE'RE GETTING TO UNDERSTAND HOW
ALL THIS WORKS IN THE BRAIN.
SO, BASICALLY WHEN PEOPLE SAY
TO YOU NOW, THIS IS WHAT THE
UNIVERSITY OF TORONTO, A LOT OF
RESEARCH HAS BEEN DISCOVERED,
DISCOVERED, WHEN YOU SAY YOUR
MEMORY'S BAD.
YOU ASK WHICH ONE?
THERE ARE AT LEAST FIVE
DIFFERENT MEMORY SYSTEMS,
INDEPENDENT AND INTERACTIVE.
OKAY?
SO, WE'LL GO THROUGH THEM
QUICKLY.
SO, THE EPISODIC MEMORY.
OKAY, EPISODIC MEMORY IS
BASICALLY THE EXPLICIT OR
CONSCIOUS RECOLLECTION OF
INCIDENTS THAT OCCURRED AT A
PARTICULAR TIME AND PLACE IN
ONE'S PERSONAL PAST.
SEMANTIC MEMORY IS ALL THE
KNOWLEDGE, AND THE FACTS AND
THE CONCEPT THAT IS NOT LINKED
TO ANY PARTICULAR TIME AND
PLACE.

A slide reads "Episodic memory: Explicit recollection of incidents that occurred at a particular time and place in one’s personal past. Semantic memory: General knowledge of facts and concepts that is no linked to any particular time and place."

He continues WHAT THE HELL DOES THAT MEAN?
OKAY, THAT MEANS THAT OTTAWA IS
THE CAPITOL OF CANADA.
RIGHT?
THAT'S A FACT.
I WENT SKATING IN OTTAWA LAST
YEAR FEBRUARY 14, ON THE CANAL
WITH MY KIDS AND WE HAD, WE ATE
BEAVER TAILS.
RIGHT?
THAT IS AN EPISODE IN MY LIFE.
A VERY SPECIFIC TIME AND PLACE
THAT OCCURRED TO ME PERSONALLY.
OKAY?
THIS REALLY GOES, YOU KIND OF
LOSE SOME OF THIS WITH NORMAL
AGING AND SEVERELY, OKAY, WITH
DEMENTIA.
BUT THIS HERE REMAINS.
OKAY?
NOW, PROCEDURAL MEMORY IS
ACQUISITION OF SKILLS AND
HABITS, IS ANOTHER TYPE OF
MEMORY.
IT'S KNOWING HOW, RATHER THAN
KNOWING THAT.

The slide changes to "Procedural memory: For the acquisition of skills and habits. Knowing ‘how’ rather than knowing ‘that’. Acquired gradually over time through repetitive practice. Working memory: Concerned with short-term retention, operating over seconds. Holds information on-line for basic cognitive activities."

He continues YOU KNOW, YOU DON'T GO TO
UNIVERSITY ON HOW TO SKATE.
AH?
YOU CAN GET A PHD ON HOW TO
SKATE IN SAUDI ARABIA.
OKAY?
OR WHATEVER.
AND YOU SAY I'M GOING TO
CANADA, I'M IMMIGRATING TO
CANADA.
I'M GONNA LEARN HOW TO SKATE.
I'M GONNA SEE VIDEOS OF GUY
LAFLEUR.
I'M GONNA SEE, I'M GONNA GET A
PHD IN HOW TO SKATE.
RIGHT?
BUT YOU DON'T PUT THEM ON.
YOU COME TO MONTREAL AND WHAT
HAPPENS?
AH, YOU FALL ON THE DERRIERE.
YOU HAVE TO DO THAT.
YOU DON'T GO TO UNIVERSITY TO
HAVE A, TO, TO GOLF, OR TO, TO,
TO, TO, TO, TO, WHATEVER.

[Audience laughing]

Guy continues TO, TO, TO RIDE
A BICYCLE.
RIGHT?
WORKING MEMORY.
OKAY, THAT'S REALLY THE SHORT
TERM MEMORY.
IT'S CONCERNED WITH SHORT-TERM
RETENTION, OPERATIONS OVER
SECONDS.
TO HOLD INFORMATION ON-LINE FOR
BASIC COGNITIVE ACTIVITIES.
SO IF I, YOU KNOW, IF YOU WANT
TO DO A PHONE NUMBER AND HOLD
IT IN YOUR MIND WHILE YOU'RE
DOING IT, THAT'S WORKING
MEMORY.
IF I WOULD GIVE YOU THE WORDS
TO REMEMBER, NO, I WOULD GIVE
YOU THOSE WORDS, I DON'T KNOW,
TABLE, TAIL, TABERNOUCHE.
I WANT YOU TO GIVE THEM BACK TO
ME BUT IN ALPHABETICAL ORDER.
NOW, THAT'S WORKING MEMORY.
YOU HAVE TO THINK OF THAT.
TABERNOUCHE, TABLE, TABLE, TAB,
NO, TABERNOUCHE, TABLE, YEAH,
TABERNOUCHE, TABLE, TAIL.
OKAY?
SO THAT'S YOU'D HAVE TO REALLY,
THAT'S, THAT'S WORKING MEMORY.
AND THEN THE LAST ONE IS
PERCEPTUAL REPRESENTATION SYSTEM, WHICH IS IMPORTANT FOR
THE IDENTIFICATION OF WORDS,
IDENTIFICATION OF WORDS AND
OBJECTS ON THE BASIS OF THEIR
FORM AND STRUCTURE.

The caption changes to "Memory Systems. Perceptual Representation Systems: Important for the identification of words and objects on the basis of their form and structure."

He continues SO, I SHOW YOU THIS.
YOU DON'T EVEN HAVE TO THINK.
YOU KNOW THIS IS A PENCIL.
OKAY?
IN YOUR MIND.
SO, PERCEPTION JUST DOES IT
AUTOMATICALLY.
OR IF YOU READ THE WORD, C-A-T,
WHEN YOU'RE READING A NOVEL,
YOU DON'T HAVE TO THINK C-A-T
IS A CAT.
YOU CAN SEE IT AUTOMATICALLY.
SO, THE PERCEPTUAL SYSTEMS OF
THE BRAIN IS ANOTHER MEMORY
SYSTEMS.
THE POINT I WANT TO MAKE TO YOU
VERY STRONGLY IS THAT THERE IS
NO DISEASE THAT OUT THERE THAT
AFFECTS ALL OF THOSE MEMORY
SYSTEMS.
SO, IF YOU CAN IDENTIFY WHICH
ONES ARE DAMAGED, YOU CAN WORK
AROUND IT AND DO COMPENSATIONS.
OKAY, SO, TO PUT IT ALL
TOGETHER FOR YOU HERE WITH THIS
WONDERFUL NEW RESEARCH, NEW
SCIENCE, YOU'RE DRIVING DOWN
THE 401.
OKAY?
THE 4-0, THE 401, THE, YOU'RE
THAT, NO, YOU'RE DRIVING DOWN
THE 404.
RIGHT?

He uses the laser pointer to point at a new slide that shows a diagram.

He continues YOU KNOW, THAT'S THE ONE THAT
GOES IN THE LAKE.
RIGHT?

[Audience laughs]

Guy continues SO, YOU'RE
DRIVING DOWN THE 404, AND
YOU'RE FLOODED BY ALL KINDS OF
SENSORY INFORMATION AND THIS
LITTLE BUFFER, SENSORY BUFFER.
OKAY?
AND, AND ALL THE DIFFERENT
SENSORY SYSTEMS BUFFER, WHICH
IS THERE JUST FOR A COUPLE OF
MILLISECONDS.
200, A QUARTER OF A SECOND, AND
IT JUST GOES THROUGH THERE,
FLUSHES THROUGH LIKE NIAGARA
FALLS.
IF YOU DECIDE TO PAY ATTENTION
TO SOMETHING, OH, I CAN SEE AN
APPLE TREE THERE.
AND THIS APPLE TREE THERE
REMINDS ME OF A SPECIFIC
EPISODE WITH MY GRANDMOTHER IN
THE KITCHEN AND WE WERE COOKING
AN APPLE PIE, AND THIS EPISODIC
MEMORY AND THE WORDS I'M USING
IS ALL BROUGHT INTO THIS.
OKAY?
AND I'M REGISTERING, BECAUSE
I'M PAYING ATTENTION.
RIGHT?
IN THIS WORKING MEMORY, AND I'M
RETRIEVING IT AND TELLING MY
PASSENGER ABOUT THIS.
THEN YOU KNOW, THEN IF
REGISTRATION COMES IN HERE, OR
IF I DECIDE TO KEEP SOME
INFORMATION, SOME, SOMETHING
NEW, A NEW NAME TONIGHT, I'M
GONNA ENCODE IT, CONSOLIDATE IT
INTO LONG TERM MEMORY.
AND THEN YOU KNOW, WITH NORMAL
AGING THE BIG BREAK DOWN IS
REALLY WITH RETRIEVAL.
OKAY?
NOW, WITH DEMENTIA, YOU KNOW,
IT AFFECTS THE BRAIN AND AS YOU
PROCEED THE FOUR "A'S," YOU
KNOW, THE SEMANTIC MEMORY,
EPISODIC MEMORY, ALL OF THESE
ARE AFFECTED, EXCEPT YOU KNOW,
OTHERS THAT ARE NOT AFFECTED
LIKE PROCEDURAL, PROCEDURAL
MEMORY.
NOW, ANOTHER POINT I WANT TO
MAKE TO YOU WITH ALL THESE
DIFFERENT MEMORY SYSTEMS,
REMEMBER THE CONNECTION BETWEEN
BRAIN AND COMPLEX BEHAVIOUR, IS
THEY'RE TIED TOGETHER.
SO, ALL THESE DIFFERENT MEMORY
SYSTEMS.
OKAY?
MEMORY, SEMANTIC, EPISODE
MEMORY IS VERY MUCH LAID TO THE
HIPPOCAMPUS REGION WHICH
CONSOLIDATES NEW MEMORIES.
IMPLICIT OR SUBCONSCIOUS.
OKAY?
THESE ARE MORE LIKE WHEN YOU'RE
AWARE, YOU HAVE TO BE AWARE,
CONSCIOUS MEMORIES.
EXPLICIT, IMPLICIT, MEANING
SUBCONSCIOUS IF YOU WISH.
LIKE YOU KNOW, YOU, YOU, YOU
DON'T HAVE TO EXPLAIN HOW YOU
LEARN HOW TO RIDE A BICYCLE.
YOU JUST DO IT.
YOU'VE BEEN CONDITIONED TO EAT
EVERY MEAL, AT TWELVE, AT NOON.
THESE ARE, ARE, ARE, THIS IS
REALLY PROCESSED BY THE OLD
BRAIN WE CALL THE CEREBELLUM
AND OTHER REGIONS CALLED THE
BASIL GANGLIA.
WORKING, SHORT-TERM MEMORY IS
VERY MUCH LAID WITH A, WITH A
MACHINE, A POWERFUL MACHINE
CALLED THE THALAMUAS CONNECTED
WITH THE FRONTAL SYSTEMS.
SO, ALL THESE DIFFERENT, WHAT'S
AMAZING NOW, IS THAT WE'RE
TRYING, WE'RE NOW CONNECTING
THOSE COMPLEX BEHAVIOURS THAT
WE, WE THOUGHT WERE JUST PURE
PSYCHOLOGICAL BEFORE, AND SEE
HOW THEY'RE CONNECTED WITH THE
INSIDE BRAIN.
OKAY?
AND THIS PICTURE HERE, IS IF
YOU HAD AN AMNESTIC PATIENT IN
AN ENVIRONMENT LIKE THIS, THIS
IS AN ENVIRONMENT WHERE I WORK,
YOU WOULD NEVER KNOW HE HAD A
PROBLEM.
YOU KNOW WHY?
IF HE'S IN THIS ENVIRONMENT,
WHAT IS THERE TO BE REMEMBERED?
THERE ARE TREES THERE, THERE'S,
THERE'S MOVE.
ALL THE INFORMATION.
THE COFFEE SHOP IS THERE.
HE CAN SMELL THE COFFEE.
EVERYTHING IS THERE.
SO, WHEN YOU COMPENSATE THE
ENVIRONMENT, THIS PERSON, WHEN
HE'S NOT IN ANY PARTICULAR
CONTEXT IN A, IN A ROOM, HE'S
TOTALLY OUT OF IT.
BUT WHEN HE'S IN A, IN A, IN A
VERY RICH ENVIRONMENT, YOU,
YOU'D, YOU'D NEVER KNOW.
EXCEPT IF YOU LEFT AND CAME
BACK, HE NEVER SAW YOU.
YOU'D LOOK FAMILIAR, BUT HE
WOULD NEVER, NEVER REMEMBER.
BUT YOU KNOW, SO, I'M, I'M
TELLING YOU, ONCE WE UNDERSTAND
HOW ALL THIS WORKS WE CAN
PERFORM SOME GREAT ADJUSTMENT
PROCEDURES.
AH, AH, AH, COMPENSATIONS.
SO, YOU ARE GOING TO SEE "THE
LION KING."
OKAY?

A scene from the movie Lion King appears. It shows a woman wearing traditional clothes and deer jumping.

He continues YOU DON'T HAVE MEMORY PROBLEMS.
WHAT HAPPENS, YOU KNOW, YOU
CAN'T REMEMBER EVERYTHING,
EVERYTHING, EVERYTHING.
WE, WE PRUNE A LOT IN THE
BRAIN.
A LOT OF PRUNING.
OKAY?
NOW, PRUNING IN THE BRAIN.
SO, BECAUSE TO BE EFFICIENT.
YOU DON'T WANT TO REMEMBER
EVERYTHING.
YOU WANT TO GET RID OF A LOT OF
STUFF.
SO, MEMORY PROBLEMS IS ONE
THING, BUT FORGETTING, KNOWING
HOW TO FORGET IS ALSO VERY
IMPORTANT.
THAT'S ANOTHER LECTURE.
OKAY?

[Audience laughs]

Guy continues SO, SO, SO, YOU,
YOU, YOU NOTE AROUND THE
BEAUTIFUL.
OKAY?
NOW, THE NEXT WEEK, OKAY, WHAT
YOU REMEMBER BECAUSE APPARENTLY
THE TICKET IS WORTH JUST
WATCHING, SEEING THIS AFRICAN
WOMAN SING.
APPARENTLY, SHE'S SOMETHING
ELSE.
SO, THIS IS VERY, VERY
STRIKING.
ONE WEEK LATER, YOU KNOW WHAT
YOU DO?
IS YOU REMEMBER THE SALIENT,
BUT ALL THE OTHER DETAILS ARE
BEING, ARE BECOMING TO, ARE
BECOMING TO BEING WASHED OUT.
THREE MONTHS LATER.
WHAT HAPPENS?
ALL THE DETAILS ARE WASHED OUT,
BUT YOU REALLY REMEMBER THIS
SALIENT FEATURE.
IT'S KIND OF THE WAY IT WORKS
IN THE BRAIN.
YOU HAVE ALZHEIMER'S.
I'LL SHOW YOU WHAT HAPPENS.
OKAY?
PAS PROBLEM IN THE HERE AND
NOW?
OKAY?
IN EARLY MODERATE, ALZHEIMER'S,
PAS PROBLEM.
BUT THEN THEY WALK OUT OF THE
THEATRE.
OKAY?
NOT EVEN 15 MINUTES.
WHOOPS, WASHED OUT.
NOT THREE MONTHS LATER, THE
NEXT MORNING.
IT'S ALL WASHED OUT.
OKAY?
SO, IT'S LIKE A TEFLON IN SOME
WAYS.
SO, JUST TO GIVE YOU AN IDEA OF
NORMAL, ABNORMAL AGING.
OKAY?
SO, I'M ALMOST FINISHED, I'M
ALMOST FINISHED.

A white layer slowly hides the picture.

He continues SO NOW, THE LAST ONE "E."
OKAY?
EXECUTIVE FUNCTIONS, THE
ABILITY TO PLAN AND EXECUTE
COMPLEX MOTOR PROGRAMS OR WE
CALL THOSE BEHAVIOURS.
OKAY?
FRONTAL SYSTEM IS WHAT
DISTINGUISHES US FROM YOU KNOW,
OTHER PRIMATES AND ANIMALS.
SO BASICALLY WHAT HAPPENS WITH
PATIENTS WITH FRONTAL LOBE
DAMAGE, AND BELIEVE ME THERE'S
A LOT OF THAT STUFF, THE
FRONTAL.
WE HAVE A LOT.
OKAY?
NICE SPARE IN FRONT, NOTICE,
YOU KNOW.
SO, WHAT YOU WOULD DO WITH
THOSE PATIENTS WOULD BE, THEY
TEND TO FOCUS ON A SMALL,
SMALL, LITTLE DETAIL WHEN YOU
HAVE DAMAGE THERE, AND HE CAN'T
PULL BACK.
PULL BACK AND LOOK AT THE TOTAL
CONTEXT.
YOU ASK HIM, WHAT LETTER DO YOU
SEE HERE?
THEY TELL YOU "N."
I SAYS, DO YOU SEE ANOTHER
LETTER?
HE SAYS, YES, "N."
THAT'S IT?
WELL, THERE'S A LOT OF, THERE'S
ANOTHER "N" HERE.
FINE, THERE'S A LOT OF "N'S."
SO, THEY CAN'T PULL BACK.
THEY GET STUCK ON A SMALL
DETAIL.
OKAY?
THEY GET VERY, VERY PULLED TO A
SALIENT FEATURE.
THIS IS AN ALZHEIMER PATIENT
WHO WE SAW EARLY AND WE
FOLLOWED THEM, SIX, EVERY SIX
MONTHS.
OKAY?
AND YOU'D ASK HIM DRAW A CLOCK,
PUT IN ALL THE NUMBERS AND SET
THE TIME AT TEN AFTER ELEVEN.
SOUNDS EASY, SOUNDS EASY.
BUT YOU KNOW, THAT TEN AFTER IS
NOT A TEN IT'S A TWO.
YOU HAVE TO ABSTRACT.
IT'S VERY COMPLEX.
WHAT DO THEY DO?

A picture of an elevator appears. He points at it and continues
THEY STUCK TO THE VERY SALIENT
INFORMATION.
TEN, ELEVEN, TEN, ELEVEN.
RIGHT?
AND THEY DO IT WRONG.
YOU CAN GIVE THEM AN I.Q. TEST
THEY DO VERY WELL, BECAUSE
YOU'D KNOW IT OR YOU DON'T.
YOU GIVE THEM THIS SMALL TASK,
THEY CAN'T DO THAT.
HERE HE WAS ABLE TO DO IT, YOU
KNOW, AHH, THEY PUT THE ONE
HERE, AHH, AND THEY WERE ABLE
TO DO A LOT OF WORK HERE, NO
WAY, TEN, ELEVEN.
HERE, TEN, ELEVEN.
BUT THERE WAS ANOTHER PROBLEM
HERE.
IT'S CALLED PERCEPTUAL NEGLECT,
WHEN YOU HAVE DAMAGE TO THE
ASSOCIATION AREA OF THE RIGHT
TEMPORAL -û REGION.
YOU TEND NOT TO PAY ATTENTION
TO THE OPPOSITE SIDE, THE LEFT
SIDE.
SO, YOU CAN SEE HOW THIS WORKS.
OKAY?
SO, NOW HOW THIS FRONTAL
FUNCTIONS OR OTHER DEMENTIAS
COULD AFFECT WORKING IN THE
ENVIRONMENT?
OKAY, THEY'RE COMING TO MY
OFFICE.
OKAY?
A PATIENT WITH FRONTAL
DYSFUNCTIONS.
THEY'RE COMING TO MY OFFICE AND
ALL THOSE DEMENTIAS HAVE YOU
KNOW, FRONTAL DYSFUNCTIONS,
BECAUSE FRONTAL LOBE IS THE
BIG, BIG PORTION.
WHAT THEY DO, I SIT OVER HERE
AND I WATCH THOSE PATIENTS
COMING IN.
YOU KNOW WHAT THEY DO?
IF YOU WANT TO GO UP TO MY
UNIT, OKAY, YOU HAVE TO PRESS
HERE TO GO UP, PRESS HERE TO GO
DOWN.
YOU KNOW WHAT THEY DO?
THEY PRESS THE OBVIOUS THING
WHICH IS THE BIG ARROW, AND IT
DOESN'T WORK.
THE DOORS OPEN, WHAT DO THEY
SEE?
A SIGN THAT SAYS DO NOT ENTER,
ACTUALLY IT SAYS DO NOT SMOKE.
BUT YOU KNOW, RED SIGNS, WHOOP,
DON'T COME IN.
AND THEY START LOOKING
CONFUSED.
AH?
OKAY, THEN THEY GET INTO THE
ELEVATOR.
SOMEBODY NICE BRINGS THEM IN
THERE.
I WANT TO SEE, A WHO?
THE NAME, DR. PROULX, YEAH,
FOURTH FLOOR.
WELL, THE DOORS OPEN ON THE
SECOND FLOOR AND LOOK WHAT YOU
GET.
OKAY?
WHEN THE DOORS OPEN, OKAY,
TYPICAL HOSPITAL, EY?
LOOK AT THAT 2F, THAT A WAY.
2E THAT A WAY.
EDUCATION ONTO FLORIDA.

[Audience laughs]

Guy continues 2X, 2X, WHERE IS
IT?
WHAT IS THIS, EXECUTIVE?
WHAT'S THE LOGIC?
WELL, IT TOOK ME A LONG, LONG,
LONG, LONG TIME, BUT THERE WAS
ANOTHER FRENCHMAN AT BAYCREST
WHO CHARTED THE PHYSICAL PLAN.

[Audience laughing]

Guy continues AND, AND IT TOOK
ME TWO YEARS TO FIGURE OUT WHAT
HE MEANT 2H, AND IT WAS LIKE,
HADMINISTRATION.

[Audience laughing]

Guy continues AND THIS POOR
FELLOW YOU KNOW, HAS DIED YOU
KNOW, SO, TOUCH WOOD.

[Knocks wood]

Guy says OKAY, HE'S DEAD
NOW.
COME IN.
YEAH.

[Audience laughs]

Guy continues OKAY, SO, OKAY,
NOW LET'S, AND THIS IS MY
OFFICE.
LOOK AT THAT.
EXIT, THAT A WAY, THAT A WAY,
EXIT.

[Audience laughs]

Guy continues I, I WANT TO GET
IN SOMEWHERE.
RIGHT?
YOU HAVE COGNITIVE DISORDER YOU
CAN'T GET IN NO HOSPITAL.

[Audience laughing]

Guy continues SO, THE PROBLEM
THE PATIENT THAT, YOU KNOW, THE
PROBLEM THAT I SOLVED TOOK TWO
HOURS.
THAT WAS WITHIN NORMAL RANGE.
NOT REMEMBERING HIS WIFE WAS
THE PROBLEM.
OKAY?

[Audience laughs]

Guy continues NO, YOU THINK IS
FUNNY.
IT'S NOT ALL THAT FUNNY, MY
FRIENDS.
OKAY?

A picture shows a toilet with several holding bars and protections.

Guy continues HOW DO YOU FLUSH THE DAMN
THING, HUH?

[Audience laughing]

Guy continues THIS IS, THIS IS
WHERE I WORK.
WE SPECIALIZE IN COGNITIVE
DISORDERS.
YOU KNOW, ASTRONAUTS CAN'T DO
THIS.
WE GOT TO FLUSH IT IN THE BACK

-
AND WHAT ARE THOSE GIZMOS, YOU
KNOW?
AND THEN WHEN I GOT THERE IN
86, OKAY, SO, WE'RE BEHAVIOUR
NEUROLOGISTS, NEURO-
PSYCHOLOGISTS, NEURO-
PSYCHIATRISTS, SPECIALISTS
GALORE.
IT SAID HERE PULL CHAIN FOR
HELP.

[Audience laughing]

Guy continues AND THEN THEY
PUT MASKING TAPE OVER HERE, AND
THEY PUT A LITTLE YELLOW SIGN
WITH AN EXCLAMATION MARK AND A
STAR WHICH SAYS, DO NOT PULL
THE CHAIN TO FLUSH THE TOILET.

[Audience laughing]

Guy continues SO, HEY, MY
FRIENDS, I TELL YOU, THE LINE
HERE, WE CAN, WHAT'S, THE POOR,
YOU KNOW, HERE'S ANOTHER
EXAMPLE OF THE CONFUSED
PATIENTS.
RIGHT?
WE PUT THIS IN THE...
WAS IT THE PATIENT WHO WAS
CONFUSED OR WAS THE ENVIRONMENT
CONFUSING, OR WAS THE
ENVIRONMENT DISABLING?
OH, YES.
NOT ONLY THAT, MY FRIENDS, I
THINK THAT CONFUSING,
DISABLING, ENVIRONMENTS,
STRESSFUL ENVIRONMENTS, COULD
ACTUALLY IF YOU FOLLOW MY
LOGIC, COULD ACTUALLY
EXACERBATE THE DISEASE PROCESS,
MAKE IT WORSE AND OKAY, REALLY.
SO, YOU CAN REDUCE A LOT OF
DISABILITY BY AH, BY AH, A LOT
OF DISABILITY BY REALLY LOOKING
AT THE ENVIRONMENT AND REDUCING
THE, THE, MAKE THEM A LOT MORE
FUNCTIONAL.
OKAY, LAST FEW SLIDES, IS TO
TALK ABOUT SOME EXCITING NEW
DEVELOPMENTS IN THE FIELD.
OKAY?
SO, EARLY INTERVENTION IS
REALLY WHERE IT'S GOING AND
VERY HOT.
MCI'S, MILD COGNITIVE
IMPAIRMENT, REMEMBER THAT.
AH, REDUCING IMPAIRMENTS WITH
NEW DRUGS, STEM CELLS, BRAIN
PLASTICITY, ALL NEW AREAS OF
RESEARCH, CLINICAL RESEARCH.
SO, MCI, OKAY, WHAT, WITH THIS,
WITH THIS, WITH THIS IS VERY
INTERESTING.

A slide reads "Early intervention. Reduce impairments with: New drugs, stem cells, activating brain plasticity."

He continues THIS IS CLINICAL RESEARCH.
WE ARE NOT DOING THIS
CLINICALLY.
WE'RE DOING RESEARCH ON IT, AND
IT'S VERY INTERESTING.
WHAT WE SEE HERE, MEDICAL
DOCTORS, FAMILY DOCTORS, ALWAYS
SEND PEOPLE YOU KNOW, BECAUSE
MEDICINE IS PATHOLOGY.
OKAY?
WHEN YOU'RE DYSFUNCTIONAL,
YOU'RE SENT TO A, YOU GO TO SEE
A DOCTOR.
WHEN THINGS ARE NOT WORKING.
AND THEY GO SEE THE DOCTOR AND
SAY, WELL, MY MEMORY'S NOT WHAT
IT WAS.
YOU KNOW, THEY HAVE SUBJECTIVE
MEMORY COMPLAINTS.
BUT THE DOCTORS ASK QUESTIONS
ABOUT HOW THEY'RE WORKING AT
HOME.
THEY'RE DOING VERY WELL IN
THEIR DAILY ACTIVITIES.
REMEMBER DEMENTIA, WE SAID
PEOPLE BECOME DEPENDENT IN
ACTIVITIES OF DAILY LIVING?
THEY'RE NOT DEPENDENT.
THEY'RE DOING FINE.
SO, THE MEDICAL FAMILY DOCTOR
SAYS COME AND SEE ME IN SIX
MONTHS.
THEY COME AND SEE HIM IN SIX
MONTHS, THEY'RE STILL DOING
OKAY.
OKAY?
NOW WHEN THEY START BECOMING
DYSFUNCTIONAL THEY SEND HIM TO
SPECIALISTS, BEHAVIOUR
NEUROLOGISTS, NEURO-
PSYCHOLOGISTS, AND THAT'S WHEN
WE SEE THEM.
WHAT WE'RE DOING NOW, WE GO TO
THE FAMILY DOCTOR'S OFFICE AND
WE SAY WHEN YOU SEE SOMEBODY,
WHEN YOU SEE SOME, SOME OF YOUR
PATIENTS WHO HAVE SUBJECTIVE
MEMORY COMPLAINTS, CAN WE SEE
THEM?
WE SEE THEM, WE GIVE THEM
MEMORY TESTS, AND WE TAKE THOSE
WHO HAVE SIGNIFICANT PROBLEMS
ON MEMORY.
ONE, YOU KNOW, THEY HAVE A
PROBLEM ON MEMORY.
WE BRING EM IN.
OKAY?
AND WHEN WE FOLLOW THESE PEOPLE
OVER FIVE YEARS, 50, OVER 50 percent
OF THESE PEOPLE CONVERT INTO
FULL BLOWN DEMENTIA.
SOME DON'T.
WHY DON'T THEY?
WE HAVE TO STUDY ALL OF THAT.
OKAY?
SO NOW, WHEN YOU FOLLOW PEOPLE
WHO PROGESS INTO DEMENTIA, HAVE
EARLY, EARLY SIGNS, WE FOUND,
WE FIND NEW EXCITING THINGS.

A slide features the different areas of the human brain.

Guy continues WE FIND THAT THIS AREA HERE OF
THE BRAIN, THE ANTHRO -- CORTEX
IS THE FIRST ONE TO BE DAMAGED.
THE SECOND ONE IS THE
HIPPOCAMPUS, EPISODIC MEMORY IS
VERY IMPORTANT OVER HERE,
LAYING DOWN NEW MEMORIES.
AND THIS FRONTAL SYSTEMS HERE
ARE, ARE THE THIRD ONE TO GO
DOWN.
OKAY?
SO NOW, IF WE MAKE THE
CONNECTIONS WITH EVERYTHING
ELSE, GO DOWN LOWER INTO THE
BRAIN, I TOLD YOU A LITTLE BIT
BEFORE ABOUT THE BASIL
FOREBRAIN NUCLEI IN ALZHEIMER'S
DISEASE, AND THEN THAT, YOU
KNOW, THESE LITTLE NUCLEI COULD
BE SUBDIVIDED INTO THREE.
THE FIRST ONE TO DETERIORATE IS
THIS ONE.
SO THIS ONE PROJECTS THESE
NEURO-TRANSMITTERS, THE
CHOLINERGIC, THE NEURO-
TRANSMITTERS PROJECT INTO
WHERE?
THE HIPPOCAMPUS AND THE ANTHRO
CORTEX.
THIS ONE IS THE SECOND ONE INTO
THE FRONTAL SYSTEMS.
SO, YOU KNOW WHAT YOU'RE SEEING
IS THAT HOW THE COMPLEX
BEHAVIOUR AS THEY GET WORSE, AS
THEY DETERIORATE, MATCH WITH
THE, THE BRAIN REGIONS, ANATOMY
AND ALSO THE NEURO-
TRANSMITTERS.
AND THOSE NEURO-TRANSMITTERS
CALLED THE CHOLINERGIC SYSTEM.
BY THE WAY, ALL THE DRUGS THAT
WE NOW GIVE FOR PEOPLE WHO HAVE
ALZHEIMER'S ARE CHOLINERGIC
ENHANCING DRUGS.
AND WE'RE NOW TRYING TO TWEAK
ALL OF THIS, BECAUSE YOU KNOW,
THOSE CHOLINERGIC ENHANCING
DRUGS, THOSE CHOLINERGIC
SYSTEMS, ACTUALLY ACTIVATES
DIFFERENT TYPES OF RECEPTORS,
NICOTINIC, MUSCARINIC,
DIFFERENT TYPES OF RECEPTORS.
AND YOU KNOW, SO WE WANT TO
TWEAK THAT IN RESEARCH AND TRY
TO BE A LOT MORE SOPHISTICATED,
AND THEN MAYBE ONE DAY WE'LL
GET EVEN CLOSER TO, TO, TO
THOSE CURES.
STROKES, OKAY, THERE'S NEW
PROTOCOLS NOW.
STROKES IN THE BRAIN IS A BIT
LIKE A BRUISED APPLE.
YOU CAN HAVE THIS AREA OF
DAMAGE HERE AND AFTER A LITTLE
WHILE, ALL THE SURROUNDING
AREA, WE CALL THAT -û EFFECT IN
THE BRAIN, DIE OUT.
OKAY?
SO NOW, WHAT THEY DO, AND WHEN
PEOPLE HAVE A STROKE ATTACK,
ANOTHER STROKE, THEY CALL IT
STROKE ATTACK, THEY GO TO THE
HOSPITAL, THEY GIVE THEM A
CERTAIN DRUG.
OKAY?
AND WHAT THAT DRUG DOES IS THAT
THEY KIND OF PUTS ALL THE
REGIONAL NEURONS AROUND HERE TO
SLEEP A LITTLE BIT.
AND THEN AFTER THAT THEY
WITHDRAW THIS DRUG, AND WHAT
YOU GET IS, YOU CONTAIN THE
DAMAGE.
SO, WHAT THAT MEANS IN TERMS OF
THE BRAIN, IS THAT YOU COULD
CONTAIN THE DAMAGE FROM ALL THE
REGION HERE, AND, AND THEN YOU
COULD REDUCE THE DEGREE OF
COGNITIVE DISORDERS
DRAMATICALLY, BECAUSE OF THOSE
NEW MEDICAL PROCEDURES.
WE HEAR A LOT, WE HEAR ABOUT
STEM CELLS.
WE NOW KNOW THAT THERE ARE STEM
CELLS WHERE?
IN, IN THE HIPPOCAMPUS.
WE'LL BE ABLE TO, TO, TO COAX
SOME OF THOSE CELLS ONE DAY.
WELL, THERE'S A LOT OF RESEARCH
WE'RE NOT THERE.
YOU'LL BE HEARING A LOT ABOUT
THAT.
YOU ARE ACTUALLY.

A picture shows an old man playing chess.

Guy continues AND THEN YOU SEE PATIENTS, THIS
MAN HERE HAD A STROKE ON THE
RIGHT SIDE OF HIS BRAIN.
OKAY?
AND WHAT WE HAVE HIM DO IS
VERY, VERY SPECIFIC PROBLEMS
RELATED TO HIS PROBLEM, TO HIS
DISEASE.
OKAY?
TO HIS BRAIN DAMAGE WHICH IS A
PERCEPTUAL PROBLEM.
YOU HAVE TO HAVE HIM DO A
PERCEPTUAL TASK.
YOU TRAIN HIM ON THIS FOR ABOUT
TWO OR THREE WEEKS, AND THIS
MAN HAD DAMAGE ABOUT TWO YEARS
AGO.
SO-CALLED RECOVERED.
AND WHAT WE SEE IN THE BRAIN IS
THAT, WE CAN NOW LOOK AT THE
BRAIN, WHAT HAPPENED IS THAT
THE BRAIN, THE PART OF THE
BRAIN, THE LEFT SIDE WHICH IS
NOT DAMAGED IS COMPENSATING.
SO, WE CAN SEE NOW IF WE DO
APPROPRIATE TRAINING OF
BEHAVIOURS, VERY WELL TARGETED,
THOSE BEHAVIOURS CAN TRAIN OR
ACTIVATE NERVE GROWTH FACTORS
IN THE BRAIN.
AND BY COMBINING YOU KNOW,
DRUGS WITH VERY SPECIFIC
BEHAVIOURS, YOU KNOW, WE CAN
GET A LOT MORE EFFECTIVE
RESULTS, AND THEN THE BRAIN
COULD COMPENSATE.
ON THIS CASE, THE OPPOSITE SIDE
OF THE BRAIN SHOWS MORE
ACTIVITY.
SO, TO RECAP.
OKAY?
I'VE TALKED ABOUT THE BRAIN.
OKAY?
I'VE TALKED ABOUT BEHAVIOUR,
ENVIRONMENT.
YOU KNOW, WE'RE GETTING TO
ACTUALLY TACKLE THE BRAIN
DISORDER ITSELF.
I TALKED ABOUT COMPENSATION.
I DON'T WANT TO MINIMIZE THAT.
OKAY?
BECAUSE I HAVE A MEDICAL
PROBLEM.
RIGHT?
I CAN'T SEE.
OKAY?
AND BECAUSE I HAVE THIS MEDICAL
PROBLEM, IT'S PROGRESSIVE.
THE OPHTHALMOLOGIST SAYS, GUY,
IT'S GETTING WORSE AND WORSE,
AND BELIEVE ME, IT'S BAD.
I PAY 300 DOLLARS EXTRA TO LOOK
GOOD.
OKAY?

[Audience laughs]

Guy continues IT'S BAD.
NOW, BECAUSE OF THIS BIOLOGICAL
PREMNA PROBLEM AND IT TENDS TO
GET WORSE.
I HAVE A TERRIBLE DISABILITY.
I CAN'T DRIVE MY CAR.
I'M TOTALLY DYSFUNCTIONAL.
NOW, THEY CAN'T DO NOTHING
RIGHT NOW, BUT THIS THING HERE
HAS BEEN AROUND FOR 300 YEARS,
AND I'M TELLING YOU, BYE-BYE,
DISABILITY.
I'M FUNCTIONAL ALL OF A SUDDEN.
RIGHT?
SO, WHEN I TALKED ABOUT THE
DEMENTIAS AT THIS LEVEL YOU CAN
GET DRAMATIC IMPROVEMENTS.
OKAY?
AT THE, AT THE BEHAVIOURAL AND
ENVIRONMENTAL LEVELS.
OKAY?
SO, MY LAST SLIDE.

A slide shows a human brain with a power cord.

Guy continues THE BRAIN, FOR US TO HAVE A
MIND, THE MIND, TO EXIST, THE
MIND HAS TO BE PLUGGED,
PLUGGED, THE BRAIN HAS TO BE
PLUGGED INTO A CONTEXT.
OKAY?

A new picture displays an old man holding a little baby.

Guy concludes AND I'VE TALKED A LOT ABOUT
ABNORMAL AGING, DEMENTIA,
MEDICAL SCHOOLS, THAT'S WHAT
THAT'S ALL ABOUT.
AND YOU KNOW, SO, BUT AGING,
AGING IS NOT, IS NOT DISEASE.
AGING IS A PRIVILEGE.
SOME OF US, THIS MAN HAS
ALZHEIMER'S DISEASE IS NOT SO
LUCKY.
BUT I WANT TO POINT OUT THAT
THIS LITTLE GIRL HE HAS IN HIS
ARMS, OKAY, IS AMNESTIC.
ALL OF YOU UNTIL THE AGE OF
THREE OR FOUR WERE TOTALLY
AMNESTIC.
OKAY?
AND WHAT'S HAPPENING IS THAT
ONE OF THE AMNESTIC, BECAUSE
THIS GENERATION, OUR GENERATION
PASSES NEW KNOWLEDGE, AND NEW
HABITS, AND NEW CULTURE TO
THIS, SO THEY CAN REWIRE THEIR
PROGRAMS AND NERVE BRAIN
FUNCTIONS.
WHY?
TO BE ABLE TO TAKE THAT WISDOM
AND, AND, AND THEN, AND THEN
MAYBE HELP AND ERADICATE SOME
OF THE DISEASE AND MAKE OUR
WORLD A BETTER WORLD.
THANK YOU VERY MUCH FOR THIS
OPPORTUNITY.
I APPRECIATE IT VERY MUCH.

[Audience applauding]

Watch: Guy Proulx on Geriatric Care - Wisdom Versus Dementia