Sinkende Neuerkrankungsraten für Demenzen? – Implikationen für eine public-health-orientierte Prävention

Neue Befunde

Demenzerkrankungen zählen zu den häufigsten und folgenschwersten psychischen Störungen im Alter, für den Einzelnen, aber auch für die Solidargemeinschaft. Für Deutschland liegen die jährlichen Kosten aus gesamtgesellschaftlicher Perspektive (AgeCoDe-Studie) für leichte Demenzen bei 15 000 Euro, für mittelschwere Demenzen bei 32 000 Euro und bei schweren demenziellen Erkrankungen bei 42 000 Euro [1].

Aktuelle Hochrechnungen gehen davon aus, dass die Zahl Demenzkranker in Europa bis 2050 auf 14 Millionen steigen wird [2].

• Literatur

• 1 Leicht H, Heinrich S, Heider D et al. Net costs of dementia by disease stage. Acta Psychiatr Scand 2011; 124: 384-395
• 2 Mura T, Dartigues JF, Berr C. How many dementia cases in France and Europe? Alternative projections and scenarios 2010–2050. Eur J Neurol 2010; 17: 252-259
• 3 Norton S, Matthews FE, Brayne C. A commentary on studies presenting projections of the future prevalence of dementia. BMC Public Health 2013; 13: 1
• 4 Matthews FE, Arthur A, Barnes LE et al. Medical Research Council Cognitive Function and Ageing Collaboration. A two-decade comparison of prevalence of dementia in individuals aged 65 years and older from three geographical areas of England: results of the Cognitive Function and Ageing Study I and II. Lancet 2013; 382: 1405-1412
• 5 Christensen K, Thinggaard M, Oksuzyan A et al. Physical and cognitive functioning of people older than 90 years: a comparison of two Danish cohorts born 10 years apart. Lancet 2013; 382: 1507-1513
• 6 Qiu C, von Strauss E, Bäckman L et al. Twenty-year changes in dementia occurrence suggest decreasing incidence in central Stockholm, Sweden. Neurology 2013; 80: 1888-1894
• 7 Mangialasche F, Kivipelto M, Solomon A et al. Dementia prevention: current epidemiological evidence and future perspective. Alzheimers Res Ther 2012; 4: 6
• 8 DiMarco LY, Marzo A, Muñoz-Ruiz M et al. Modifiable Lifestyle Factors in Dementia: A Systematic Review of Longitudinal Observational Cohort Studies. J Alzheimers Dis
• 9 Brown BM, Peiffer JJ, Martins RN. Multiple effects of physical activity on molecular and cognitive signs of brain aging: can exercise slow neurodegeneration and delay Alzheimer’s disease?. Mol Psychiatry 2013; 18: 864-874
• 10 Luck T, Riedel-Heller SG, Luppa M et al. Apolipoprotein E epsilon 4 genotype and a physically active lifestyle in late life: analysis of gene-environment interaction for the risk of dementia and Alzheimer’s disease dementia. Psychol Med 2013; 44: 1319-1329
• 11 Erickson KI, Voss MW, Prakash RS et al. Exercise training increases size of hippocampus and improves memory. Proc Natl Acad Sci U S A 2011; 108: 3017-3022
• 12 Erickson KI, Weinstein AM, Lopez OL. Physical activity, brain plasticity, and Alzheimer’s disease. Arch Med Res 2012; 43: 615-621
• 13 Sperling RA, Aisen PS, Beckett LA et al. Toward defining the preclinical stages of Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7: 280-292
• 14 Dubois B, Feldman HH, Jacova C et al. Research criteria for the diagnosis of Alzheimer’s disease: revising the NINCDS–ADRDA criteria. Lancet Neurol 2007; 6: 734-746
• 15 Jack Jr CR, Albert MS, Knopman DS et al. Introduction to the recommendations from the National Institute on Aging – Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7: 257-262
• 16 Albert MS, DeKosky ST, Dickson D et al. The diagnosis of mild cognitive impairment due to Alzheimer’s disease: recommendations from the National Institute on Aging – Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7: 270-279
• 17 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition (DSM-V). Arlington: APA; 2013
• 18 Solomon A, Mangialasche F, Richard E et al. Advances in the prevention of Alzheimer’s disease and dementia. J Intern Med 2014; 275: 229-250
• 19 Barnes DE, Yaffe K. The projected effect of risk factor reduction on Alzheimer’s disease prevalence. Lancet Neurol 2011; 10: 819-828
• 20 Reither EN, Olshansky SJ, Yang Y. New forecasting methodology indicates more disease and earlier mortality ahead for today’s younger Americans. Health Aff (Millwood) 2011; 30: 1562-1568
• 21 Schneider LS, Mangialasche F, Andreasen N et al. Clinical trials and late-stage drug development for Alzheimer’s disease: an appraisal from 1984 to 2014. J Intern Med 2014; 275: 251-283