Prävention und Therapie demenzieller Erkrankungen mittels körperlicher Aktivität

Zusammenfassung

Demenzen sind die häufigsten psychischen Störungen im höheren Lebensalter, mit einer weiteren Zunahme ist zu rechnen. Bei der Therapie sind Fortschritte zu verzeichnen, dennoch sind den Behandlungserfolgen noch enge Grenzen gesetzt. Da sich demenzielle Erkrankungen über einen langen Zeitraum und vermutlich auch unter dem Einfluss bestimmter Lebensgewohnheiten entwickeln, gilt es, das Augenmerk auf präventive Interventionen zu legen. Daten prospektiver Studien sprechen dafür, dass regelmäßige körperliche Aktivität, die sich bereits im mittleren Lebensalter etabliert hat, von präventivem Nutzen ist. Möglicherweise beinhaltet körperliches Training auch therapeutische antidementive Effekte. Die Ergebnisse tierexperimenteller Untersuchungen weisen darauf hin, dass körperliche Aktivität die Genexpression verschiedener neurotropher Faktoren induziert und Einfluss auf die Gehirnvaskularisierung, die Neurotransmission, die Neurogenese und die Neuroplastizität nimmt. Neuroplastische und neuroprotektive Effekte sind insbesondere im Bereich des Hippocampus zu registrieren, was für demenzielle Erkrankungen von besonderer Bedeutung sein könnte. Empirischen Daten sprechen dafür, dass regelmäßige körperliche Aktivität ein Beitrag zur Gehirngesundheit/psychischen Gesundheit ist, experimentelle Befunde weisen darauf hin über welche neurobiologischen Mechanismen diese positiven Effekte entstehen könnten. Die Ergebnisse beider Forschungsrichtungen legen also nahe, bei der Prävention und Therapie demenzieller Erkrankungen mehr Gewicht als bisher auf körperliches Training zu legen.

Abstract

Dementias are among the most frequent geriatric mental disorders and will increase in the decades to come. With regard to therapeutic strategies, some progress is seen on the one hand, but its clinical impact appears to be limited still. Dementias usually proceed over a longer period of time and are probably influenced by lifestyle factors implying that preventive interventions are to be considered. Data from prospective studies suggest that regular sportive activity having been established during midlife can be of preventive value. Possibly this contains therapeutic antidementive effects too. Results from animal experiments on the other hand led to the assumption that physical activity induces increased gene expression of neurotrophic factors and influences (thereby) cerebral vascularisation, neurotransmission, neuroneogenesis and neuroplasticity. These effects were especially being seen in the hippocampal region which we hypothesize to be of particular relevance with regard to dementias. Empirical data indicate that regular physical activity may contribute to cerebral health - which is mental health; experimental findings refer to modes of action which are supposed to be responsible for those positive effects. This implies that more emphasis is to be placed on regular workout as a therapeutic and - most of all - preventive antidementive means.

Schlüsselwörter

Demenz - Ausdauertraining - körperliche Aktivität - Therapie - Prävention

Key words

dementia - continuous workout - physical activity - therapy - prevention

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