Neues zur Alzheimer Erkrankung

Zusammenfassung

Die Demenz vom Alzheimer-Typ (DAT) ist eine weltweit exponentiell zunehmende Erkrankung, die von einer nicht finanzierbaren Kostenexplosion begleitet sein wird. Bei den aktuellen, zugelassenen medikamentösen Therapien, die schweregradabhängig eingesetzt werden, handelt es sich um symptomatische Behandlungsansätze. Aufgrund von reger Grundlagen- und klinischer Forschung gelingt es zunehmend, genetische und pathophysiologische Veränderungen zu konkretisieren sowie differenzierte Risikogruppen und krankheitsmodifizierende Therapieansätze zu identifizieren. Erkenntnisse aus epidemiologischen Studien legen beeinflussbare Risikofaktoren nahe, auch wenn bis heute positive Interventionsstudien fehlen. Die Häufung negativer Ergebnisse aus kontrollierten Studien mit dem Ziel der Neuroprotektion im Stadium der Demenz einerseits sowie die positive Entwicklung von in vivo Biomarkern andererseits, führen zu einer Revision des Konzeptes „Alzheimer Erkrankung“, bei dem die Demenz als Spätstadium akzeptiert und gegenüber therapeutisch potentiell leichter zugänglichen Früh- und Vorformen abgegrenzt wird. Die vorliegende Übersichtsarbeit bezieht sich bis auf wenige Ausnahmen auf Veröffentlichungen der Jahre 2010 und 2011.

Abstract

Alzheimer’s dementia (AD) is a neurodegenerative disease whose incidence is increasing exponentially worldwide. The conceivable costs will burden health and state economies heavily. Currently approved drug therapies act merely symptomatically. Continuous scientific work on genetics and pathophysiology has identified different risk groups and disease-modifying therapeutic strategies. Epidemiological data allow us to draw conclusions with regard to modifiable risk factors. However, they are exclusively of unspecific character. Negative results of clinical trials on neuroprotection in Alzheimer’s dementia and promising experience with in vivo biomarkers, have led to a revision of the concept “Alzheimer’s disease”, which differentiates between late stage “dementia” and potentially modifiable earlier stages of “pre-symptomatic” and “symptomatic non-dementia”. This review refers to publications mainly of the years 2010 and 2011.

Schlüsselwörter

Alzheimer Erkrankung - Genetik - Pathophysiologie - Biomarker - Konzeptwandel

Keywords

Alzheimer’s disease - genetics - pathophysiology - biomarker - new concepts

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