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Östrogene und Alzheimer-Demenz

Estrogens and Alzheimer’s disease

  • Leitthema
  • Published:
Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

Die Prävalenz demenzieller Erkrankungen beträgt bei den über 75-Jährigen etwa 5%, in der Gruppe der über 80-Jährigen liegt sie sogar über 10%. Damit gehören demenzielle Erkrankungen zu den häufigsten Leiden des höheren Erwachsenenalters. Pathoanatomischen Studien zufolge sind etwa 2 Drittel der Fälle auf die Alzheimer-Demenz (AD) zurückzuführen. Therapeutisch sind allgemeinmedizinische Maßnahmen, psychosoziale Interventionen sowie die Pharmakotherapie kognitiver Defizite und nichtkognitiver Symptome indiziert. Allerdings sind die verfügbaren Therapieoptionen mit Blick auf einen anhaltenden Therapieerfolg unbefriedigend. Daher kommt adjuvanten Therapien, die eine Modifikation des Krankheitsverlaufs bewirken können, große Bedeutung zu. In diesem Zusammenhang stellt der vorliegende Beitrag potenzielle therapeutische und präventive Effekte von Östrogenen auf Manifestation und Verlauf der AD vor.

Abstract

Prevalence rates of dementia range from about 5% in patients older than 75 years up to more than 10% in those older than 85 years, making dementia the most common disorder in old age. According to follow-up studies, most cases (50%–60%) could be characterised as Alzheimer’s disease (AD). Clinically, mnestic and other cognitive dysfunctions represent the core symptoms of AD. It is well known that estrogens exhibit several psychotropic effects in humans and that a relative lack of endogenous estrogens may be involved in the pathogenesis of AD. Recent studies have provided evidence of systematic activation effects of estrogens on cerebral activity and cognitive function. Epidemiological studies have investigated the potential of estrogens to modify AD onset and progression. There was evidence for a beneficial effect of estrogen replacement therapy on AD with a reduction in incidence of approximately 50%. In addition, it has been speculated that estrogens may also exhibit beneficial effects on the clinical course of AD. The present article reviews current evidence in favour of the beneficial neurotropic and psychotropic effects of estrogens in AD.

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Authors and Affiliations

  1. Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, AöR, Semmelweisstr. 10, 04103, Leipzig, Deutschland

    P. Schönknecht

  2. Sektion Gerontopsychiatrie, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Deutschland

    J. Schröder

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  1. P. Schönknecht
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  2. J. Schröder
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Correspondence to P. Schönknecht.

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Schönknecht, P., Schröder, J. Östrogene und Alzheimer-Demenz. Gynäkologische Endokrinologie 9, 19–23 (2011). https://doi.org/10.1007/s10304-010-0389-3

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