Erfahrungsheilkunde 2023; 72(01): 53-59
DOI: 10.1055/a-1997-7091
Praxis

Patienten mit ersten Anzeichen nachlassender geistiger Leistungsfähigkeit: Was der Hausarzt nicht vergessen sollte

Peter Emmrich

Zusammenfassung

Noch immer wird die leichte kognitive Störung zu selten diagnostiziert und ärztlich behandelt. Dabei haben Forschungen der letzten Jahre gezeigt, dass verschiedene Maßnahmen das Risiko nachlassender geistiger Leistungsfähigkeit und einer eventuellen sukzessiven Demenzerkrankung mindern können. Erste Gedächtnisverluste, Verhaltensänderungen oder neuropsychiatrische Störungen im Alter sollte der Arzt nicht nur mit dem Ziel ernst nehmen, weitere Einbußen zu verzögern. Vielmehr können Patienten lange vor demenziellen Stadien bereits unter diesen Beeinträchtigungen leiden. Zu den modifizierbaren Risikofaktoren für Demenzen zählen u. a. Hörverlust, Bluthochdruck, übermäßiger Alkoholkonsum, Übergewicht, Rauchen, Depressionen, Einsamkeit, körperliche Inaktivität und Diabetes. Zur symptomatischen Behandlung altersbedingter kognitiver Beeinträchtigungen und demenzieller Erkrankungen trägt der Ginkgo-biloba-Extrakt EGb 761 bei. Aufgrund der guten Verträglichkeit von EGb 761 empfiehlt sich daher der frühzeitige Einsatz im Rahmen eines ganzheitlichen Therapiekonzepts.

Abstract

Mild cognitive impairment is still diagnosed and treated by doctors too rarely. Yet research has shown in recent years that various measures can reduce the risk of declining mental performance as well as possible successive dementia. Physicians of elderly patients therefore should take first signs of memory loss, changes in behavior or neuropsychiatric disorders seriously. This is important not only to slow down further cognitive losses. Rather, patients may be negatively impacted by said impairments long before reaching the first stage of dementia. Modifiable risk factors for dementia include hearing loss, hypertension, excessive alcohol consumption, obesity, smoking, depression, loneliness, physical inactivity and diabetes. Ginkgo biloba extract EGb 761 contributes to the symptomatic treatment of age-related cognitive impairment and dementia. Due to the good tolerability of EGb 761, its early use as part of a holistic therapy concept is therefore recommended.



Publikationsverlauf

Artikel online veröffentlicht:
20. Februar 2023

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  • Literatur

  • 1 Thyrian JR, Boekholt M, Hoffmann W. et al. The prevalence of people with dementia in Germany – a nationwide analysis at the district level. Nervenarzt 2020; 91 (11) 1058-1061
  • 2 Kasper S, Bancher C, Eckert A. et al. Management of mild cognitive impairment (MCI): The need for national and international guidelines. World J Biol Psych 2020; 21 (08) 579-594
  • 3 Livingston G, Huntley J, Sommerlad A. et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet 2020; 396 (10248) 413-446
  • 4 Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Deutsche Gesellschaft für Neurologie (DGN). S3-Leitlinie „Demenzen“. Im Internet: Zugriff am 15. Dezember 2022 unter: https://dggpp.de/leitlinien/s3-leitlinie-demenz-kf.pdf
  • 5 Schröder JP. Die leichte kognitive Beeinträchtigung. Stuttgart: Schattauer; 2011
  • 6 Mirza SS, Ikram MA, Bos D. et al. Mild cognitive impairment and risk of depression and anxiety: A population-based study. Alzh Dement 2017; 13 (02) 130-139
  • 7 Barrios H, Narciso S, Guerreiro M. et al. Quality of life in patients with mild cognitive impairment. Aging Ment Health 2013; 17 (03) 287-292
  • 8 Fitzpatrick AL, Belza B, Raetz JG. et al. Evaluating a system to promote timely detection of cognitive impairment in primary care practice. Alzh Dement 2021; 17: e055084
  • 9 Elman JA, Jak AJ, Panizzon MS. et al. Underdiagnosis of mild cognitive impairment: A consequence of ignoring practice effects. Alzh Dement 2018; 10: 372-381
  • 10 Oswald WDF, Fleischmann UM. Hrsg. Nürnberger Alters-Inventar (NAI). Nürnberg: Universität Erlangen-Nürnberg; 1994
  • 11 Kulic Z, Lehner MD, Dietz GPH. Ginkgo biloba leaf extract EGb 761® as a paragon of the product by process concept. Front Pharmacol. in press
  • 12 Cao WL, Huang HB, Fang L. et al. Protective effect of ginkgo proanthocyanidins against cerebral ischemia/reperfusion injury associated with its antioxidant effects. Neural Regen Res 2016; 11 (11) 1779-1783
  • 13 Yao J, Qiao H, Jin Z. et al. Ginkgo biloba and its constituent 6-hydroxykynurenic-acid as well as its proanthocyanidins exert neurorestorative effects against cerebral ischemia. Planta Medica 2020; 86 (10) 696-707
  • 14 Sens-Albert C, Luderer G, Kraus S. et al, eds. Proanthocyanidines from EGb 761 improve impaired short term memory. 69th International Congress and Annual Meeting of the Society for Medicinal Plant and Natural Product Research (GA). Planta Medica; 2021
  • 15 Dietz G. Ginkgo biloba. Evolution zum modernen Phytopharmakon. Phytokompass 2018; 2: 35-39
  • 16 Grass-Kapanke B, Busmane A, Lasmanis A. et al. Effects of ginkgo biloba special extract EGb 761® in very mild cognitive impairment (vMCI). Neurosci Med 2011; 02 (01) 48-56
  • 17 Gavrilova SI, Preuss UW, Wong JW. et al. Efficacy and safety of ginkgo biloba extract EGb 761 in mild cognitive impairment with neuropsychiatric symptoms: A randomized, placebo-controlled, double-blind, multi-center trial. Int J Geriatr Psych 2014; 29 (10) 1087-1095
  • 18 Gauthier S, Schlaefke S. Efficacy and tolerability of Ginkgo biloba extract EGb 761® in dementia: A systematic review and meta-analysis of randomized placebo-controlled trials. Clin Interv Aging 2014; 9: 2065-2077
  • 19 García-Alberca JM, Mendoza S, Gris E. Benefits of treatment with ginkgo biloba extract EGb 761 alone or combined with acetylcholinesterase inhibitors in vascular dementia. Clin Drug Investig 2022; 42 (05) 391-402
  • 20 Băjenaru O, Prada G, Antochi F. et al. Effectiveness and safety profile of ginkgo biloba standardized extract (EGb761®) in patients with amnestic mild cognitive impairment. CNS Neurol Disord Drug Targ; 2021 20.
  • 21 Bohlken J, Peters O, Kostev K. Association between ginkgo biloba extract prescriptions and dementia incidence in outpatients with mild cognitive impairment in Germany: A retrospective cohort study. J Alzheimers Dis 2022; 86 (02) 703-709
  • 22 Amieva H, Meillon C, Helmer C. et al. Ginkgo biloba extract and long-term cognitive decline: A 20-year follow-up population-based study. PLoS One 2013; 8 (01) e52755
  • 23 Kandiah N, Ong PA, Yuda T. et al. Treatment of dementia and mild cognitive impairment with or without cerebrovascular disease: Expert consensus on the use of ginkgo biloba extract, EGb 761® . CNS Neurosci Ther 2019; 25 (02) 288-298
  • 24 Schulz M, Hoerr R, Mueller H. Ginkgo biloba extract EGb 761: A meta-analysis of adverse event rates from randomized, placebo-controlled, double-blind clinical trials. Int J Clin Pharm 2018; 40 (01) 203-317
  • 25 Kloft C, Hoerr R. EGb 761® does not affect blood coagulation and bleeding time in patients with probable Alzheimer’s dementia – secondary analysis of a randomized, double-blind placebo-controlled trial. Healthcare (Basel) 2021; 9 (12) 1678
  • 26 Hoerr R, Zimmermann A, Dienel A. Single and repeated doses of ginkgo biloba extract EGb 761® do not affect pharmacokinetics and pharmacodynamics of rivaroxaban in healthy volunteers. Z Phytotherap 2022; 43: 31-59
  • 27 Zifko U, Yacob M, Braun B. et al. Alleviation of Post-COVID-19 cognitive deficits by treatment with EGb 761®: A case series. Am J Case Rep; 2022 in press