Demenz und metabolisch-vaskuläre Risikofaktoren: Möglichkeiten der Prävention

Zusammenfassung

Die Prävalenz der Demenz ist in den letzten Jahren gestiegen und nimmt mit dem Alter exponentiell zu. In Deutschland sind ca. 1,7 Mio. Menschen betroffen, die jährliche Neuerkrankungsrate wird auf 300 000 geschätzt. Der Begriff Demenz umfasst verschiedene Krankheitsformen mit unterschiedlichen Ätiologien. Dem demenziellen Syndrom des höheren Lebensalters liegen meist vaskuläre und metabolische Risikofaktoren zugrunde, die der klinischen Demenzmanifestation um Dekaden vorausgehen. Dies bietet ein enormes Zeitfenster für die Prävention, welche insbesondere vor dem Hintergrund weitgehend fehlender kurativer pharmakologischer Ansätze eine große Bedeutung erlangt. Lebensstilmaßnahmen, die eine hohe Nahrungsqualität und eine ausreichende Versorgung mit Omega-3-Fettsäuren, körperliche Aktivität und erholsamen Schlaf beinhalten, verbessern metabolische und vaskuläre Risikofaktoren und mindern das Demenzrisiko. Da multimodale Konzepte synergistisch wirken, versprechen sie den größten präventiven Nutzen.

Abstract

The prevalence of dementias is on the rise, increases exponentially with age and constitutes a major healthcare burden nationally and worldwide. Dementias are clinically heterogeneous and encompass numerous etiologies. Noteworthy, late onset dementias are closely related to vascular and metabolic risk factors in midlife. Cardiometabolic risk factors commonly precede the onset of cognitive decline for decades. This opens a huge window for prevention. Given the lack of established pharmacological options for treatment of most dementias, preventive strategies are of utmost importance. Several factors have been identified that have the potential to preserve a healthy metabolic phenotype and to attenuate the onset of late onset dementias. Evidence exists for low-risk lifestyle factors including a real food dietary pattern, an adequate supply with long chain omega-3 fatty acids, regular physical activity and restorative sleep, with multimodal concepts showing the greatest cumulative benefit.

Schlüsselwörter

Lebensstilfaktoren - Demenz - Prävention - Insulinresistenz - Ketonkörper

Key words

lifestyle factors - dementia - prevention - insulin resistance - ketone bodies

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