Zusammenfassung
Die Behandlung der Alzheimer-Demenz stützt sich aktuell auf symptomatische Therapieansätze. Medikamente, die den Verlauf der Krankheit positiv beeinflussen, befinden sich in verschiedenen Stadien der Entwicklung und klinischen Prüfung. Aufgrund der teilweise ungeklärten Pathogenese sind Rückschläge in der Entwicklung solcher Neuansätze vorprogrammiert. Klinisch-epidemiologische Beobachtungen, die einen neuroprotektiven Effekt von Statinen und nichtsteroidalen Antirheumatika nahelegen, müssen hinsichtlich ihrer molekularen Zusammenhänge weiter aufgeklärt werden. Verlaufsmodifizierende Therapien wirken möglicherweise nur Jahre bis Jahrzehnte vor Beginn der klinischen Apparenz. Daher stellt die Behandlung internistischer Risikofaktoren wie Fettleibigkeit und Hypertonie im mittleren Lebensabschnitt sowie die Ernährung mit mediterraner Diät derzeit eine sinnvolle präventive Maßnahme mit hohem Potenzial zur Verlaufsmodifikation dar.
Summary
The current therapy of Alzheimer’s disease is primarily symptomatic. Drugs which aim to modify the course of the disease are currently being developed and tested in clinical trials. Given the complex and partly unknown pathogenesis of the disease, failure of such forms of therapy has to be taken into account. Clinical epidemiology suggests a possible neuroprotective effect of statins and non-steroidal anti-inflammatory drugs, however, the molecular basis of these effects has to be further unraveled. Therapies that modify the course of Alzheimer’s disease are only likely to be effective years if not decades before the disease becomes clinically apparent. Thus, the therapy of risk factors including arterial hypertension and obesity in midlife as well as a Mediterranean diet currently provides the highest chance of modifying the course of the disease.
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Heneka, M. Verlaufsmodifizierende Therapien der Alzheimer-Demenz. Nervenarzt 81, 807–814 (2010). https://doi.org/10.1007/s00115-010-3000-1
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DOI: https://doi.org/10.1007/s00115-010-3000-1