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Morbus Alzheimer — Epidemiologie, Diagnose und Therapie

Alzheimer’s Disease — Epidemiology, Diagnosis and Therapy

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Zusammenfassung

Morbus Alzheimer ist eine neurodegenerative, progrediente und irreversible Erkrankung und die häufigste und bekannteste Demenzerkrankung. Zurzeit ist etwa 1% der deutschen Gesamtbevölkerung betroffen. Die Wahrscheinlichkeit an Alzheimer zu erkranken, steigt exponentiell mit dem Lebensalter. Auf Grund der höheren Lebenserwartung sind Frauen gegenüber Männern bisher mit einem Anteil von 7:3 deshalb stärker betroffen. Für das Jahr 2050 rechnet man mit einer Patientenzahl von 2,3 Millionen.

Die Krankheitsursachen sind nicht völlig geklärt. Es gibt einige seltene vererbte Fälle, der Mehrzahl der Erkrankungen liegen mehrere Ursachen/Lebensumstände zugrunde. Die Zelldegeneration, die über 10–30 Jahre dauert, findet in den tiefer liegenden Anteilen des Temporal- und Parietallappens und weniger im Frontallappen statt. Eine eindeutige Diagnose kann erst post mortem durch eine histopathologische Untersuchung des Gehirnbiopsats erfolgen.

Generell kommt es zu einem individuell stark unterschiedlichen Verlust der Merkfähigkeit und des Gedächtnisses. Aktuell steht eine symptomatische Therapie zur Verfügung. Acetylcholesterase-Hemmer und NMDA-Rezeptor-Antagonisten werden hierfür eingesetzt.

Präventiv scheinen eine ausgewogene Ernährung, körperliche Bewegung und geistige Aktivitäten zu wirken.

Abstract

Alzheimer’s Disease is a progressive, degenerative and irreversible brain disorder and the most widespread and well-known form of dementia. Currently 1% of the German population is affected. The risk to suffer from this disease increases with age. This is the reason why women, who generally live longer, are affected more often than men (7:3). Estimations for the year 2050 predict more than 2,3 millions patients.

The causes of AD are not fully understood. The disease course runs from ten to thirty years and affects mainly the parietal and the temporal lobe. There are some rare inherited cases, but for most cases there is an interaction of genetic, environmental and life-style risk factors, with age playing the largest part.

The rate and quality of decline varies from patient to patient. Clear proof of AD can only be obtained by examining the brain after death.

Drug treatment can relieve some symptoms such as cholinesterase inhibitors including donezepil, galantamine and rivastigmine or NMDA receptor antagonist (memantine).

A well-balanced diet, regular physical and mental exercises play an important role in prevention.

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  1. Institut für Arbeitsmedizin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin & Humboldt-Universität zu Berlin, Thielallee 69-73, 14195, Berlin, Deutschland

    Salome Tropp, Karin Vitzthum, Stefanie Mache, Bianca Kusma, Norman Schöffel, Stefanie Uibel, David A. Groneberg & David Quarcoo

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  1. Salome Tropp
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  2. Karin Vitzthum
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  3. Stefanie Mache
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Correspondence to Karin Vitzthum.

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Tropp, S., Vitzthum, K., Mache, S. et al. Morbus Alzheimer — Epidemiologie, Diagnose und Therapie. Zbl Arbeitsmed 60, 92–99 (2010). https://doi.org/10.1007/BF03344264

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